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Gastric dilatation and volvulus
/content/chapter/10.22233/9781910443248.chap6
Gastric dilatation and volvulus
- Author: John M. Williams
- From: BSAVA Manual of Canine and Feline Abdominal Surgery
- Item: Chapter 6, pp 89 - 103
- DOI: 10.22233/9781910443248.6
- Copyright: © 2015 British Small Animal Veterinary Association
- Publication Date: November 2015
Abstract
Gastric dilatation and volvulus (GDV) is an acute life-threatening abnormal accumulation of gastric gas (dilatation), which may be complicated by rotation of the stomach (volvulus) about its mesenteric axis. This chapter looks at pathophysiology, diagnosis and management, techniques and treatment. Operative techniques: Tube gastropexy; Belt loop gastropexy; Incisional gastropexy.
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Figures
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6.1
Ventral view of 180-degree rotation of the stomach. (a) Pylorus moves ventrally from right to left. (b) Pylorus and body of stomach move clockwise. (c) Pylorus lies to left of stomach. (d) Pylorus moves more dorsally. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2015 British Small Animal Veterinary Association
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6.1
Ventral view of 180-degree rotation of the stomach. (a) Pylorus moves ventrally from right to left. (b) Pylorus and body of stomach move clockwise. (c) Pylorus lies to left of stomach. (d) Pylorus moves more dorsally. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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6.5
Right lateral radiograph showing gastric volvulus. (© John Williams) © 2015 British Small Animal Veterinary Association
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6.5
Right lateral radiograph showing gastric volvulus. (© John Williams)
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6.7
ECG traces. (a) Ventricular premature contractions (VPCs). Note that every fourth beat is a VPC (arrowed). (b) Ventricular tachycardia. Note wide ‘bizarre’ QRS complexes. © 2015 British Small Animal Veterinary Association
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6.7
ECG traces. (a) Ventricular premature contractions (VPCs). Note that every fourth beat is a VPC (arrowed). (b) Ventricular tachycardia. Note wide ‘bizarre’ QRS complexes.
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6.8
(a) A 7.5 cm adhesive bandage roll with plastic core. (b) The roll placed ‘end-on’ orally with similar tape wrapped around the dog’s muzzle to facilitate passage of a stomach tube. (© John Williams) © 2015 British Small Animal Veterinary Association
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6.8
(a) A 7.5 cm adhesive bandage roll with plastic core. (b) The roll placed ‘end-on’ orally with similar tape wrapped around the dog’s muzzle to facilitate passage of a stomach tube. (© John Williams)
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6.9
Gastric lavage. (a) Recumbent dog undergoing gastric lavage. (b) ‘Typical’ contents from gastric lavage. (© John Williams) © 2015 British Small Animal Veterinary Association
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6.9
Gastric lavage. (a) Recumbent dog undergoing gastric lavage. (b) ‘Typical’ contents from gastric lavage. (© John Williams)
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6.10
Dog’s clipped right flank, prepared aseptically and with a 16 G intravenous needle inserted. (© John Williams) © 2015 British Small Animal Veterinary Association
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6.10
Dog’s clipped right flank, prepared aseptically and with a 16 G intravenous needle inserted. (© John Williams)
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6.12
Omentum ‘covering’ a clockwise-rotated stomach. The stomach serosa is inflamed and potentially ischaemic. (© John Williams) © 2015 British Small Animal Veterinary Association
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6.12
Omentum ‘covering’ a clockwise-rotated stomach. The stomach serosa is inflamed and potentially ischaemic. (© John Williams)
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6.13
Pylorus being lifted gently from left (L) to right. (© John Williams) © 2015 British Small Animal Veterinary Association
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6.13
Pylorus being lifted gently from left (L) to right. (© John Williams)
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6.14
Erythematous (inflamed) serosa on the greater curvature of stomach following GDV. (© John Williams) © 2015 British Small Animal Veterinary Association
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6.14
Erythematous (inflamed) serosa on the greater curvature of stomach following GDV. (© John Williams)
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6.15
Invagination. (a) Cross-sectional view of the greater curvature to show invagination (the stippled area is the non-viable area). (b) Invagination in process, using a continuous suture pattern. (c) Invagination completed. (Photographs © John Williams). Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2015 British Small Animal Veterinary Association
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6.15
Invagination. (a) Cross-sectional view of the greater curvature to show invagination (the stippled area is the non-viable area). (b) Invagination in process, using a continuous suture pattern. (c) Invagination completed. (Photographs © John Williams). Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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Foley catheter being drawn into the abdominal cavity.
Foley catheter being drawn into the abdominal cavity. © 2015 British Small Animal Veterinary Association
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Foley catheter being drawn into the abdominal cavity.
Foley catheter being drawn into the abdominal cavity.
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Foley catheter being introduced into the stomach (pyloric antrum) after pre-placing a purse-string suture.
Foley catheter being introduced into the stomach (pyloric antrum) after pre-placing a purse-string suture. © 2015 British Small Animal Veterinary Association
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Foley catheter being introduced into the stomach (pyloric antrum) after pre-placing a purse-string suture.
Foley catheter being introduced into the stomach (pyloric antrum) after pre-placing a purse-string suture.
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Omentum wrapped around the catheter. (© John Williams)
Omentum wrapped around the catheter. (© John Williams) © 2015 British Small Animal Veterinary Association
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Omentum wrapped around the catheter. (© John Williams)
Omentum wrapped around the catheter. (© John Williams)
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Relative positions of the catheter, stomach and body wall.
Relative positions of the catheter, stomach and body wall. © 2015 British Small Animal Veterinary Association
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Relative positions of the catheter, stomach and body wall.
Relative positions of the catheter, stomach and body wall.
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Roman Sandal suture. (© John Williams)
Roman Sandal suture. (© John Williams) © 2015 British Small Animal Veterinary Association
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Roman Sandal suture. (© John Williams)
Roman Sandal suture. (© John Williams)
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A tongue of seromuscular tissue is created from the stomach wall over the pyloric antrum, incorporating two short gastric arteries.
A tongue of seromuscular tissue is created from the stomach wall over the pyloric antrum, incorporating two short gastric arteries. © 2015 British Small Animal Veterinary Association
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A tongue of seromuscular tissue is created from the stomach wall over the pyloric antrum, incorporating two short gastric arteries.
A tongue of seromuscular tissue is created from the stomach wall over the pyloric antrum, incorporating two short gastric arteries.
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Two parallel incisions are made in the transversus muscle of the abdominal wall, caudal to the costal arch; a tunnel, wider than the flap, is created by blunt dissection with artery forceps.
Two parallel incisions are made in the transversus muscle of the abdominal wall, caudal to the costal arch; a tunnel, wider than the flap, is created by blunt dissection with artery forceps. © 2015 British Small Animal Veterinary Association
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Two parallel incisions are made in the transversus muscle of the abdominal wall, caudal to the costal arch; a tunnel, wider than the flap, is created by blunt dissection with artery forceps.
Two parallel incisions are made in the transversus muscle of the abdominal wall, caudal to the costal arch; a tunnel, wider than the flap, is created by blunt dissection with artery forceps.
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The seromuscular pedicle is drawn gently through the tunnel with Babcock forceps.
The seromuscular pedicle is drawn gently through the tunnel with Babcock forceps. © 2015 British Small Animal Veterinary Association
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The seromuscular pedicle is drawn gently through the tunnel with Babcock forceps.
The seromuscular pedicle is drawn gently through the tunnel with Babcock forceps.
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The flap is sutured into its original bed in the gastric wall.
The flap is sutured into its original bed in the gastric wall. © 2015 British Small Animal Veterinary Association
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The flap is sutured into its original bed in the gastric wall.
The flap is sutured into its original bed in the gastric wall.
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Incision in the right lateral body wall through the peritoneum and transversus abdominis muscle.
Incision in the right lateral body wall through the peritoneum and transversus abdominis muscle. © 2015 British Small Animal Veterinary Association
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Incision in the right lateral body wall through the peritoneum and transversus abdominis muscle.
Incision in the right lateral body wall through the peritoneum and transversus abdominis muscle.
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Partial thickness incision in the pyloric antrum.
Partial thickness incision in the pyloric antrum. © 2015 British Small Animal Veterinary Association
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Partial thickness incision in the pyloric antrum.
Partial thickness incision in the pyloric antrum.
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Suturing the gastric incision edges to the edges of the body wall incision with a simple continuous suture pattern (the caudal edges are sutured in the same manner).
Suturing the gastric incision edges to the edges of the body wall incision with a simple continuous suture pattern (the caudal edges are sutured in the same manner). © 2015 British Small Animal Veterinary Association
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Suturing the gastric incision edges to the edges of the body wall incision with a simple continuous suture pattern (the caudal edges are sutured in the same manner).
Suturing the gastric incision edges to the edges of the body wall incision with a simple continuous suture pattern (the caudal edges are sutured in the same manner).