In ruminants, the duodenal anatomy is unique with respect to its increased length and mobility within the abdomen. From the pylorus, the cranial duodenum courses toward the liver, where it forms the sigmoid flexure prior to returning caudally and becoming the descending duodenum. The duodenal sigmoid flexure has a double attachment to the greater (caudally) and lesser omentum (cranially).1
Naturally occurring proximal duodenal obstructions are uncommon in cattle. Reported cases include functional stenoses or strictures, liver abscesses causing cranial abdominal adhesions involving the duodenum, phytobezoars, trichobezoars, and a report of gallbladder entrapment.2–5 In a retrospective study4 comparing naturally occurring proximal duodenal obstructions with AV in cattle, significant differences were found with respect to the metabolic changes. The hypochloremic metabolic alkalosis was more severe in cattle with duodenal obstruction.
Recently, we have recognized a new condition clinically resembling AV but affecting the duodenal sigmoid flexure in dairy cattle. The purpose of the study reported here was to characterize DSFV and determine the prognosis for affected cattle undergoing surgery.
Duodenal sigmoid flexure volvulus
GIA 80 Auto Suture reloadable stapler, 4.8 mm, Tyco Healthcare, Norwalk, Conn.
2. Boerboom D, Mulon PY, Desrochers A. Duodenal obstruction caused by malposition of the gallbladder in a heifer. J Am Vet Med Assoc 2003; 223:1475–1477.
3. Braun U, Steiner A, Gotz M. Clinical signs, diagnosis and treatment of duodenal ileus in cattle. Schweiz Arch Tierheilkd 1993; 135:345–355.
4. Garry F, Hull BL, Rings DM, et al. Comparison of naturally occurring proximal duodenal obstruction and abomasal volvulus in dairy cattle. Vet Surg 1988; 17:226–233.
7. Gingerich DA, Murdick PW. Experimentally induced intestinal obstruction in sheep: paradoxical aciduria in metabolic alkalosis. Am J Vet Res 1975; 36:663–668.