This document discusses gastric dilatation-volvulus (GDV), also known as gastric torsion, in dogs. It covers the pathophysiology of GDV, clinical signs, diagnosis using radiography, preoperative care including decompression, and surgical correction procedures such as derotating the stomach and gastropexy to prevent future episodes. GDV is a life-threatening condition where the stomach dilates and rotates on its axis, causing shock and gastric necrosis if not promptly treated.

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