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Does Hemorrhagic Bowel Syndrome start with small mucosal erosions ?
De Jonge, B.; Pardon, B.; Van...
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Objectives: To describe gross and histological lesions, as well as intestinal microbiome in cases of Hemorrhagic Bowel Syndrome (HBS).
Materials & Methods: In this descriptive study, 18 cows with HBS (7 necropsied immediately following euthanasia, 11 post mortem interval >12h) were grossly and histopathologically examined post-mortem. In addition, bacteriological examination and whole metagenome nanopore sequencing of intestinal samples of affected and unaffected intestine was performed.
Results: Hemorrhagic Bowel Syndrome was characterized by a small intestinal, intramucosal hematoma with dissection of the lamina muscularis mucosa (LMM), in all animals where histological determination was possible (10/18). In 57.1% (4/7) of the fresh cases, the small intestinal mucosa proximal to the hematoma, showed 9-14 multifocal solitary or clustered small mucosal lacerations or erosions measuring 4-45mm. In 73% (37/48) of these mucosal lesions, microscopic splitting of the LMM comparable to the hematoma was present. Intestinal blood loss was more severe in animals with spontaneous death compared to euthanized animals (p = 0.038). Bacteriological cultivation and nanopore sequencing showed a polymicrobial population at the hematoma and unaffected intestine, with mostly mild presence of Clostridium perfringens. There was no infiltrative growth of fungi within the intestinal tissue.
Conclusions: HBS is characterized by an intramucosal hematoma which likely originates form small mucosal lesions through dissecting hemorrhage within the LMM. Fulminant intestinal blood loss is an important factor in the acute and lethal clinical course of this disease. Gross and microscopic pathology, as well as the culture and sequencing results, were not in support of involvement of bacterial or fungal agents in the pathogenesis of HBS.
Keywords: Jejunal hemorrhage syndrome, hematoma, intestinal, lamina muscularis mucosae, nanopore sequencing.
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Affiliation of the authors at the time of publication
Ghent University, Merelbeke, Belgium;
PathoSense BV, Lier, Belgium;
Animal Health Service Flanders, Torhout, Belgium.
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