RUPTURA DE BEXIGA URINÁRIA E FRATURA VERTEBRAL EM L5 DECORRENTES DE TRAUMA EM CÃO: RELATO DE CASO

Autores

  • Juliana Rodrigues Leitão
  • Marcelo Candido Portilho Gouveia
  • Bruno Watanabe Minto
  • Luis Gustavo Gosuen Gonçalves Dias

DOI:

https://doi.org/10.51161/rems/1825

Palavras-chave:

CIRURGIA, COLUNA VERTEBRAL, NEUROLOGIA, CISTORRAFIA, TRAUMA MEDULAR

Resumo

Introdução: As fraturas da coluna vertebral são causas potenciais de injúrias da medula espinhal em pequenos animais. Frequentemente, o paciente com trauma toracolombar têm lesões associadas em outros órgãos. Objetivos: Objetivou-se relatar um caso de ruptura da bexiga urinária e fratura completa oblíqua na 5° vértebra lombar e descrever as técnicas cirúrgicas utilizadas. Materiais e métodos: Uma cadela, Shih Tzu, com 5 anos de idade, 5 kg, foi atendido com histórico de trauma há 4 horas pela queda de um botijão de gás cheio na região toracolombar. Paraparesia, disúria, hematúria e dor abdominal eram os sinais clínicos. Ao exame neurológico, a paciente demonstrou dor acentuada na região lombar e propriocepção ausente. O paciente foi submetido ao exame radiográfico da coluna vertebral o qual indicou fratura completa oblíqua na 5° vértebra lombar. Na ultrassonografia abdominal, constatou-se líquido livre na cavidade abdominal. Realizou-se uretrocistografia retrógrada de contraste positivo, confirmando-se a ruptura da vesícula urinária. Optou-se primariamente pela cistorrafia com fio absorvível monofilamentado, padrão contínuo, invaginante Cushing e em 2 planos. Instituiu-se o tratamento clínico para fratura vertebral que incluiu confinamento estrito, imobilização externa e controle da dor (dipirona 25mg/kg SID e tramadol 2 mg/kg SID). Após dois dias, realizou-se laminectomia e estabilização lombar. A fratura em L5 foi reduzida com auxílio de pinça ponta-ponta. Dois parafusos foram colocados tanto na vértebra cranial (L4) quanto caudal (L6) à fratura, com ângulo de 45° de inserção. O cimento ósseo Cimento Ortopédico Veterinário – C-VET foi colocado em torno dos implantes. Efetuou-se o desgaste do processo espinhoso das vértebras L4, L5 e L6. Resultados: No pós-operatório imediato, a paciente foi encaminhada para internação. Foi orientado repouso absoluto por 15 dias. No sétimo dia, o animal deambulava sem dor e urinava normalmente. Após 30 dias, a paciente não apresentava alterações clínicas neurológicas, recebendo alta. Uma intervenção terapêutica rápida limita a extensão da lesão neuronal, favorecendo a recuperação do paciente. Em cães com preservação da percepção de dor profunda, o prognóstico é favorável. Conclusão: Conclui-se que em casos com histórico conhecido de traumatismo vertebral deve-se avaliar o paciente quanto a lesões concorrentes para um resultado pós-cirúrgico satisfatório.

Publicado

2021-09-02

Como Citar

Leitão, J. R., Gouveia, M. C. P. ., Minto, B. W. ., & Dias, L. G. G. G. . (2021). RUPTURA DE BEXIGA URINÁRIA E FRATURA VERTEBRAL EM L5 DECORRENTES DE TRAUMA EM CÃO: RELATO DE CASO. Revista Multidisciplinar Em Saúde, 2(3), 13. https://doi.org/10.51161/rems/1825

Edição

Seção

I Congresso On-line Nacional de Clínica Veterinária de Pequenos Animais
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