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Mechanical and functional stenoses of the duodenum (SD) are uncommon in dairy cows compared to forestomach and abomasal diseases. However, as the clinical course of SD – due to severe disturbances of the body homeostasis - is dramatic and as the condition resembles characteristics of right displacement of abomasum (RDA) and for this reason easily can be misdiagnosed, it needs further attention.
<U>Case histories:</U> Patients submitted to the clinic for cattle that were later diagnosed with SD had a history of sudden onset of anorexia and abdominal distension and were treated with calcium and glucose infusions by the local practitioner. In one case, deterioration of the clinical condition was observed following omentopexy that was performed for suspected RDA. The animals were dairy cows belonging to the Holstein Frisian breed aged between 4 and 5 and1/2 years. They were either short before calving or within 3 weeks post partum. At admittance, the cows showed signs of moderate to severe dehydration. A fluid-distended bowel was identified in the right flank by eliciting a steelband effect above the last rib and by a positive ballottement at the same site. At rectal palpation hardly any faeces were present in the rectum and only slightly distended intestinal loops, if at all, could be felt. Laboratory analysis revealed severe hypochloremic, hypokalemic, metabolic alkalosis and cholestasis. Explorative laparotomy revealed paralysis of the complete or the anterior part of the duodenum, obstruction of the duodenal lumen by geosediment or – in one case – a 270 grade torsion of a loop at the caudal flexure of the duodenum. The parts of the duodenum distal from the torsion site were found completely empty, with the oral parts being extremely overfilled and dilated. The stenoses were either treated by massage of the intestinal contents or by reposition of the dislocated duodenal loop. In the majority of cases, the acid base equilibrium returned to normal following the infusion of 10 l isotonic sodium chloride solution, as well as the electrolyte levels and the haematocrit values. Functional stenoses of the duodenum were caused either by toxaemia, or hypocalcemia, or mechanical obstruction of the duodenal lumen by accumulation of geosediment from the abomasum.