Intestinal surgery can be indicated in a variety of situations. Probably the most common reason would be to look for and remove intestinal foreign bodies. By “intestinal foreign bodies”, we mean any object that has found it’s way into the intestinal tract that in fact should not be there! These of course are many and varied. Here is a list of some of the common ones that vets find:
- Corn cobs
- String (potentially very nasty)
- Stone fruit pips
- Pebbles and small rocks
- Sticks, including kebab sticks!
- Parts of children’s toys
- Cooked bones
- Chewed up pieces of clothing
- Whole pieces of clothing (Labradors … they’ll gulp down anything!)
Intestinal foreign bodies may or may not be felt or detected on radiology. They can be one of the most difficult things to identify. Symptoms often start with lethargy and inappetance and progress to vomiting and diarrhoea If the offending agent is not easily identified by palpation, radiology or ultrasound, we may recommend an “exploratory laparotomy”. This means that we will open the abdomen up under general anaesthesia and “have a look” to see if we can find anything. This is in fact a very cost effective and productive way to at least “rule-in” or “rule-out” an intestinal foreign body and is highly recommended in cases that are confusing. If palpation or diagnostics reveal a foreign body, that’s great, surgery is indicated. But negative diagnostics do not in fact rule out the presence of a foreign body. Hence in suspect cases a quick exploratory laparotomy is indicated, as the main concern with intestinal foreign bodies is that if left too long, the intestine may become compromised. There are two main surgeries that are performed to remove a foreign body. 1)A simple intestinal or gastric incision: This is performed when a foreign body is detected within viable healthy intestinal tissue. Through a simple incision the object can be removed and the wound sutured. 2)Intestinal Anastomosis: If the intestinal tissue is not viable due to the pressure exerted on it by the foreign body, then it will need to be removed. The whole section of questionable intestine is cut out and the two healthy ends of intestine are sutured together. This is obviously a much larger and potentially more complicated procedure than the simple intestinal single incision.
This is another very common finding in gastro-enteric cases and one of the great advantages of performing an exploratory laparotomy in suspect cases. As with all cancers, some will be resectable and some will not be. This decision is often made “on the table” once the surgeon has identified the nature and extent of the problem.