臺灣博碩士論文加值系統

胃擴張扭轉症在犬及人的醫學中皆已被良好紀錄，且在其他數種品種中也有零星的報告，包括貓、猴子、豬、天竺鼠以及貂。不過，據我們所知，至近尚未有兔子胃擴張扭轉症的相關報告及研究。本研究的目的為描述且發表兔子胃擴張扭轉症的放射影像學之特徵，以及與其他也會發生此病症的品種比較其臨床表徵，提供對於診斷兔子胃擴張扭轉症的特徵及對於此病的認知。本篇為回溯性研究，病例納入標準為經由放射影像及臨床症狀來診斷或懷疑患有胃擴張扭轉症的兔子，且經由手術或屍體解剖確診。所有的臨床症狀、影像學檢查結果、血檢、術中發現及結果皆會被記錄。有五個病例符合本篇的納入標準。全部的病例皆有放射影像的右側躺照及腹背照。五個病例中有3隻利用正造影來幫助診斷。病例1的胃部不易被辨識，但可見一彎曲管狀樣的氣體輪廓位於胃部的背側，而此被認為可能是位於易位之幽門內的氣體。其他病例則皆能從有或無執行正造影的放射影像中，於腹背照下呈現一擴張且往右側易位的胃底部。全部病例皆於手術時確診為胃擴張扭轉症，且呈現順時針的扭轉。此五病例的臨床症狀包括腹部膨脹(n=3)、厭食或停止進食 (n=5)、脫水 (n=2)、精神不佳 (n=2)、活動力不佳 (n=2) 以及疼痛 (n=1)。根據本篇結果，我們認為於腹背照中辨認出一個往右側易位的胃底部對於診斷兔子的胃擴張扭轉症是較簡單且具診斷性的。此外，我們也建議對於那些出現腹部膨脹、厭食或停止進食、脫水、精神不佳、活動力不佳或疼痛等臨床症狀的兔子，應將胃擴張扭轉症列入鑑別診斷中，且需執行進一步的影像學檢查。

Gastric dilation-volvulus (GDV) is well documented in dogs and humans, and has been reported sporadically in numerous other species, including cats, monkeys, pigs, guinea pigs and ferrets (Elwell and DePaoli, 1978; Formaggini et al., 2008; Geyer and Reichle, 2012; Mitchell et al., 2010; Wendt, 1987). However, to the best of our knowledge, GDV in rabbits has not been published. The objective of this study is to describe and characterize the radiographic features of GDV in rabbits, and compare the clinical manifestations with other species for providing a diagnostic characteristic and cognition of rabbits with GDV. Inclusion criteria of this retrospective study were that the rabbit was diagnosed or suspected GDV based on the radiographs and clinical presentation, and was confirmed via surgery or necropsy. Clinical signs, radiography, blood works, surgical findings and outcomes were recorded. Five cases met the inclusion criteria. All cases had right lateral view and ventrodorsal view of radiographs. Positive contrast study was used in 3 of the 5 cases to facilitate the diagnosis. The stomach in case 1 was difficult to be recognized radiographically, but a curve-tubular gas was located at the dorsal aspect of the stomach on lateral view, which was suspected to be the gas in the displaced pylorus. Other cases presented a dilated and rightward displaced fundus on ventrodorsal view with or without positive contrast study. All of the cases were confirmed the diagnosis of GDV during the surgery. The clinical signs of the 5 cases included bloat (n=3), anorexia or stop eating (n=5), dehydration (n=2), poor spirit (n=2), poor activity (n=2), and painfulness (n=1). Based on the results, recognition of a fundus displaced to the right on ventrodorsal view is valuable for diagnosis of rabbit GDV. Moreover, GDV should be included as a differential diagnosis when rabbits are presented with above-mentioned clinical signs, and further imaging examination should be performed.

摘要 i
Abstract ii
Contents iv
Table Contents vi
Figure Contents vii
Chapter 1 Introduction 1
Chapter 2 Literature Review 4
2.1. Gastric dilation-volvulus and gastric volvulus 4
2.1.1. Pathophysiology 4
2.1.2. Etiology and risk factors 7
2.1.3. Clinical signs 8
2.1.4. Diagnosis 9
2.1.4.1. Blood work 9
2.1.4.2. Imaging 10
2.1.5. Management 12
2.1.5.1. Stabilization and medical therapy 12
2.1.5.2. Surgery 13
Chapter 3 Materials and Methods 15
3.1. Study design and inclusion criteria 15
3.2. Clinical presentation 15
3.3. Radiography examination 15
3.4. Managements and surgery 16
3.5. Medical treatment 17
3.6. Prognosis 17
Chapter 4 Result 18
4.1. Rabbits 18
4.2. Radiographic finding 18
4.3. Surgical finding 20
4.4. Prognosis 21
Chapter 5 Discussion 32
5.1. Radiographic features 32
5.2. Clinical signs 34
5.3. Etiology and risk factors 36
5.4. Surgical finding and management 37
5.5. Blood work 39
5.6. The limitation 39
5.7. Conclusion 40
References 42
Appendix 50

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