Right displaced abomasum: surgical technique

• Right-sided displacement of the abomasum (RDA) usually precedes abomasal volvulus (AV) although both are often simply referred to as RDA.
• Right sided displacement without volvulus is less common than Left sided displacement Left sided displacement, or abomasal volvulus with LDA:RDA ratio of 30:1 and LDA:AV ratio of 10:1.
• Once volvulus occurs, RDA is a life-threatening emergency in contrast to LDA.
• Surgical correction is the only treatment for RDA with volvulus.

Uses

• Correction of RDA with or without volvulus.
• Treatment of cases of RDA without volvulus which have failed to respond to medical treatment.

• Only technique available to correct RDA with volvulus.
• Also allows correction of other conditions with similar presentations, eg caecal torsion.

• Patient often extremely unwell leading to poorer outcomes.
• Surgery can be difficult.

Technical problems

• It can be difficult to discern the direction and plane of volvulus in order to return the abomasum to its normal anatomical position.

Alternative techniques

• Conservative treatment of simple RDA without volvulus may be successful.

Time required

• 20 minutes.

• 40-60 minutes.

Decision taking

• It is important to assess likely prognosis for each individual case, and discuss whether surgery is economically viable.
• Animals showing signs of severe metabolic alkalosis, depression and toxemia should be considered at high risk of death. Tachycardia, recumbency, poor peripheral perfusion or injected mucous membranes are all poor prognostic indicators.
• Stabilisation of fluid and electrolyte imbalance is often required before surgery Fluid therapy.