Localised mid-jejunal volvulus following intussusception and enteroplication in a dog

Comparative short-term and long-term outcomes between internal and external intestinal plication in the management of small bowel obstruction

Background

Small bowel obstruction (SBO) is common and usually requires surgical intervention. Intestinal plication is a traditional but critical strategy for SBO in certain scenarios. This study is to compare the short-term and long-term outcome between internal and external plications in the management of SBO.

Methods

All patients receiving intestinal plication in our hospital were retrospectively collected. Short-term outcome including postoperative complications, reoperation, postoperative ICU stay, starting day of liquid diet and postoperative hospitalization, as well as long-term outcome including recurrence of obstruction, readmission, reoperation and death were compared between groups. Gut function at annual follow-up visits was evaluated as well.

Results

Nine internal and 11 external candidates were recruited into each group. The major causes of plication were adhesive obstruction, abdominal cocoon, volvulus and intussusception. Lower incidence of postoperative complication (p = 0.043) and shorter postoperative hospitalization (p = 0.049) was observed in internal group. One patient receiving external plication died from anastomosis leakage. During the 5-year follow-up period, the readmission rate was low in both groups (22.2 % vs. 9.1 %), and none of patients required reoperation or deceased. None of patients exhibited gut dysfunction, and all patients restored normal gut function after 4 years. Patients in external group demonstrated accelerated recovery of gut function after surgery.

Conclusions

This study compares short-term and long-term outcome of patients receiving internal or external intestinal plication. We suggest a conservative attitude toward external plication strategy. Surgical indication for intestinal plication is critical and awaits future investigations.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12893-021-01304-1.

Current Views in the Diagnosis and Treatment of Intestinal Intussusception

Intestinal intussusceptions most often occur in young dogs and cats. Common locations for intestinal intussusceptions include enterocolic, eneteroenteric or colocolic. Ultrasonography is highly reliable for diagnosing of intussusception and for prediction of its reducibility. Abdominal structures that may mimic intussuception can be seen ultrasonographically. Intussusceptions is a surgical emergency. Immediate stabilization of the animal followed by manual reduction or intestinal excision of the affected intestine through midline celiotomy are required. Recurrence is a common postsurgical complication. Enteroplication may be considered for recurrence prevention but is not without complications. Prognosis is good in uncomplicated cases.

Investigation of potential risk factors for mesenteric volvulus in military working dogs

OBJECTIVE To identify risk factors for mesenteric volvulus (MV) in military working dogs (MWDs). DESIGN Retrospective case-control study. ANIMALS 211 MWDs (54 with and 157 without MV [case and control dogs, respectively]). PROCEDURES Medical records (cases and controls) and necropsy reports (cases) were reviewed. Signalment, pertinent medical and surgical history, behavior and temperament characteristics, feeding schedules, and training types were recorded. Weather patterns for regions where dogs resided were researched. Data were evaluated statistically to identify potential risk factors for MV. RESULTS Risk factors significantly associated with MV included German Shepherd Dog breed (OR, 11.5), increasing age (OR, 2.0), and history of prophylactic gastropexy (OR, 65.9), other abdominal surgery (after gastropexy and requiring a separate anesthetic episode; OR, 16.9), and gastrointestinal disease (OR, 5.4). Post hoc analysis of the subset of MWDs that underwent gastropexy suggested that postoperative complications were associated with MV in these dogs but type of gastropexy and surgeon experience level were not. CONCLUSIONS AND CLINICAL RELEVANCE Data supported earlier findings that German Shepherd Dog breed and history of gastrointestinal disease were risk factors for MV. The MWDs with a history of prophylactic gastropexy or other abdominal surgery were more likely to acquire MV than were those without such history. These findings warrant further study. Despite the association between prophylactic gastropexy and MV, the authors remain supportive of this procedure to help prevent the more common disease of gastric dilatation-volvulus.

Predisposing Factors for Colonic Torsion/Volvulus in Dogs: A Retrospective Study of Six Cases (1992–2010)

The purposes of this retrospective study were to review cases of colonic torsion/volvulus between July 1992 and August 2010 and to determine if any predisposing factors exist for the development of this condition. Six dogs were diagnosed with colonic torsion/volvulus during the study period. Four dogs had a history of previous gastric dilation-volvulus (GDV) with prophylactic gastropexy. Three of six dogs diagnosed with colonic torsion/volvulus had large intestinal entrapment and strangulation around the gastropexy site at the time of surgery. The history, clinical signs, physical examination, and radiologic findings were not specific for colonic torsion/volvulus in any dog. Early exploratory laparotomy was indicated to confirm the diagnosis and perform surgical correction of the affected bowel segments. Three of five dogs that underwent surgery had a left abdominal wall colopexy performed. All five dogs that underwent surgery in this study survived postoperatively. One patient was euthanized without surgical intervention. Results suggest that colonic torsion/volvulus should be considered in any large-breed dog with nonspecific gastrointestinal clinical signs and a history of previous gastropexy. Early recognition and prompt treatment of this condition may result in a good outcome.