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

  1. Field of operation , laparotomy means an incision in the abdominal cavity
  2. 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

1. Soft food feeding is vital after Gastrotomy

2. Antibiotics for 3 days at least

3. NSAID/ Analgesic is recommended

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