History
- A 2 years old dog was presented to us with stop feeding and vomiting with feeding trials.
- Radiographic examination of chest and abdomen revealed presence of foreign body in the stomach
- Gastroscopy was tried as first option for withdrawal of the foreign body per Os with no outcomes.
- Surgical interference (Celiotomy) was recommended for removal of the foreign body.
Surgical procedure
- Field of operation , laparotomy means an incision in the abdominal cavity
- Incision at the midline and linea alba.
Opening of the abdominal cavity
- Take care not to injure any of internal structures accidentally, so it is preferred to elevate the incision edge and then use a scissor to widen the incision cranially and caudally.
- Extract the stomach from the abdominal cavity carefully.
Here three important points:
1. Padding and placing sponges around the stomach is very important to prevent contamination.
2. Determine the site of gastric opening. it is preferred to be in a spot with little blood vascular tree (could be seen by eye) , at the greater curvature of the stomach.
3- Take two stay sutures, then between the two knots, use the scalpel to make stab incision inside the stomach between the two stay suture knots.
- Stab incision at the gastric wall
- Widening the incision cranially and caudally.
- widening the incision cranially and caudally
- trying to extract the foreign body from inside the stomach with an artery forceps.
- Hair ball extraction hair out of stomach
Gastric washing
- Suturing the gastric mucosa with simple continuous pattern 4/0 vicryl
- Closing the gastric serosa / muscleman with simple interrupted pattern 4/0 vicryl
- After gastric wall closure
- Omentopexy , aiming to decrease the intraabdominal adhesions
- Closing the abdominal wall first layer with simple interrupted suture technique
- Second layer was closed by running sub-cuticular cosmetic surgery
Postoperative Care
1. Soft food feeding is vital after Gastrotomy
2. Antibiotics for 3 days at least
3. NSAID/ Analgesic is recommended