Gastric foreign body and Gastrotomy

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 stomachGastric 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 surgeryPostoperative Care