1. • Veterinary Gastrointestinal surgery
(Part-II)
• Presented by
• Dr. Rekha Pathak
• Senior scientist , IVRI
The photographs have been collected from
different sources i.e. Internet, text books
etc

2. Gastric acute dilatation and
torsion
• Gastric dilatation-
volvulus (GDV)
• Only dilation common
in puppies
• Overeating/
parasitism
• Larger and giant
breeds – deep
chested

3. • Overeating –
relieved by induced
vomiting or passing
stomach tube
• Parasitism
• Pica
• Postprandial
activity
• Delayed gastric
emptying-
pyloromyotomy

4. • Pathophysiology
• Rotation after dilation
• Aerophagia – source
of intragastric gas
• Distended stomach
(gas + fluid) – more
prone to rotation
• Prevents eructation –
esophagus and
emptying from
duodenum
• Distension increases

5. • Presses the caudal vena/ portal vein –
reduced venous return – red. CO. –
red. Tissue perfusion and shock
• Ischemic bowel – release toxins-
endotoxemia-shock and hypotension
• Red. Ventilation- pressure on
diaphragm

6. • Acid base and electrolyte disturbance
• Myocardial ischemia
• Rotation of stomach – strangulation
of gastric vessels- edema and anoxia
–gastric wall ulceration and necrosis

7. • Clinical signs
• Acute onset of cranial abd. Distention
• Vomiting
• Profuse salivation-pain
• Prolonged CRT, Pallor, weak pulse
• Shock (pooling of blood in spleen due to rotation
of splenic vessels, hypovolemia and
hypotension)
• Dyspnea

8. • RG signs: differentiate simple gastric
distension from GDV
• Gas filled stomach- 50-75% - splenic
position is normal if no volvulus
• In GDV –pylorus is located cranial/dorsal –
fundus
• Position of spleen may not be normal

9. • A tissue density line
dividing the gas filled
stomach into
compartments
• VD - pylorus is near
or near to the left of
the midline
• Gastric perforation-
pneumoperitoneum
• Clockwise 270
• Anticlockwise 90

10. • Preoperative care
• Gastric
decompression
• Needle
trocarization 18 G
needle
• Thrust on rt. Or
left wall – point of
greatest distension

11. • 2-3 needles – relieves
gas component of
distension
• Alternatively – if not
effectively reduced –
stomach
• Pass the s.tube
through mouth gag-
resistance is
encountered in gastro
esophageal junction –
rotate and advance

12. • Removal of
intragastric gas –
trocarization- corrects
the gastro esophageal
angle-allows passage
of S. tube
• Passage of st doesn’t
mean absence of g.
rotation
• Withdraw the tube
after decompression

13. • Sometimes for
decompression –
temporary Gastrotomy is
constructed
• Close the Gastrotomy
wound and proceed for
surgical correction of
rotation (Decompression
doesn’t always result in
normal gastric position)
• Shock therapy

14. • Surgical correction of volvulus
• If surgery is delayed – gastric necrosis worsens
• Reposition the stomach by derotating it
• Avoid injury to splenic v. (digital palpation of
esophagus reveals the direction of rotation
• Pylorus is a good / useful landmark – firm
consistency)
• See the viability of gastric tissue – necrosed
and non-viable – esp. the greater curvature is
damaged

15. • Serosal color,
thickness of wall and
vascular patency
• Partial gastrectomy
• Hemoperitoneum -
centesis of abdominal
cavity- splenic torsion
and gastric torsion
• Blue-black
areas/diffuse
petechial /ecchymotic
stomach- gastrectomy
not indicated –
becomes normal after
decompression

16. • Spleenectomy – damaged
• Gastropexy- red. Rate of
GDV
• Pyloric antral region is
fixed to the adjacent rt.
abdominal wall
• Gastropexy is always
performed on the rt. Side
of the stomach – some
rotation – still occur-
bet.left gastric wall and
left abd.wall