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The large intestine and perineum
British Small Animal Veterinary Association , 139 (2015); https://doi.org/10.22233/9781910443248.8
/content/chapter/10.22233/9781910443248.chap8
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The large intestine and perineum

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Abstract

Differentiation of large bowel disease from small intestinal disorders is based on history and clinical examination. The clinical signs are a result of disruption of the functions of the large bowel – namely, absorption of water and electrolytes from luminal contents, and storage and periodic expulsion of faecal material. This chapter addresses anatomy, diagnosis and treatment of many different conditions. Colotomy; Colectomy; Typhlectomy (caecal resection); Incision colopexy; Anal ‘pull-out’ procedure for lesions requiring full-thickness resection; Rectal ‘pull-through’ procedure; Dorsal rectal approach; Ventral approach to the rectum; Perineal herniorrhaphy in a male dog; Anal sacculectomy; Anoplasty.

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Figures

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8.1
Anatomy and vascular supply of the large intestine. 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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8.1 Anatomy and vascular supply of the large intestine. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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8.2
Vasa recti supplying the descending colon. The left colic artery anastomoses with the middle colic artery and supplies the descending colon by numerous vasa recti, and not the anastomosing arcades seen in the small intestines. © 2015 British Small Animal Veterinary Association
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8.2 Vasa recti supplying the descending colon. The left colic artery anastomoses with the middle colic artery and supplies the descending colon by numerous vasa recti, and not the anastomosing arcades seen in the small intestines.
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8.4
(a) Caecal leiomyosarcoma in a cat. (b) Cross-section of removed tumour. © 2015 British Small Animal Veterinary Association
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8.4 (a) Caecal leiomyosarcoma in a cat. (b) Cross-section of removed tumour.
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8.5
Abdominal radiograph showing the caecum impacted with mineralized material, immediately caudal to rib 13. © 2015 British Small Animal Veterinary Association
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8.5 Abdominal radiograph showing the caecum impacted with mineralized material, immediately caudal to rib 13.
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8.6
Abdominal radiographs of a 4-year-old Rottweiler bitch with caecal–colic volvulus. Note the dilated colon, ending abruptly cranial to the pelvic inlet (arrowed). © 2015 British Small Animal Veterinary Association
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8.6 Abdominal radiographs of a 4-year-old Rottweiler bitch with caecal–colic volvulus. Note the dilated colon, ending abruptly cranial to the pelvic inlet (arrowed).
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8.9
Lateral radiograph of a cat with idiopathic megacolon. © 2015 British Small Animal Veterinary Association
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8.9 Lateral radiograph of a cat with idiopathic megacolon.
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8.10
Contrast radiograph obtained using a barium enema. Arrows outline a filling defect in ventral colorectal wall. © 2015 British Small Animal Veterinary Association
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8.10 Contrast radiograph obtained using a barium enema. Arrows outline a filling defect in ventral colorectal wall.
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8.11
The perineal stand position. Note that the table should not be tilted more than 25–30 degrees. 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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8.11 The perineal stand position. Note that the table should not be tilted more than 25–30 degrees. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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8.12
Anal ‘pull-out’ and local excision. For small lesions, full-thickness resection is not always required. 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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8.12 Anal ‘pull-out’ and local excision. For small lesions, full-thickness resection is not always required. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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8.13
Radiograph of Boxer puppy with Type III atresia ani. © 2015 British Small Animal Veterinary Association
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8.13 Radiograph of Boxer puppy with Type III atresia ani.
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8.14
Imperforate anus (atresia ani). © 2015 British Small Animal Veterinary Association
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8.14 Imperforate anus (atresia ani).
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8.17
Radiograph showing an enlarged iliac lymph node. (Reproduced from the ) © 2015 British Small Animal Veterinary Association
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8.17 Radiograph showing an enlarged iliac lymph node. (Reproduced from the )
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8.18
Horizontal section through perineal area. 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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8.18 Horizontal section through perineal area. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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8.19
Schematic drawing of perineal anatomy. (Reproduced from the ) © 2015 British Small Animal Veterinary Association
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8.19 Schematic drawing of perineal anatomy. (Reproduced from the )
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8.21
Perineal musculature. 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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8.21 Perineal musculature. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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8.22
(a) Rectal sacculation. (b) Rectal diverticulum (rare; note the mucosa protruding through the muscularis and serosal layers of rectum). 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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8.22 (a) Rectal sacculation. (b) Rectal diverticulum (rare; note the mucosa protruding through the muscularis and serosal layers of rectum). Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
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8.23
Pneumocystogram of a Cocker Spaniel bitch with perineal hernia and retroflexed bladder. © 2015 British Small Animal Veterinary Association
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8.23 Pneumocystogram of a Cocker Spaniel bitch with perineal hernia and retroflexed bladder.
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8.26
(a) Large perineal swelling, suggestive of a perineal hernia. (b) Perineal hernia being confirmed by rectal examination; note the lack of lateral rectal wall support. (Reproduced from the ) © 2015 British Small Animal Veterinary Association
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8.26 (a) Large perineal swelling, suggestive of a perineal hernia. (b) Perineal hernia being confirmed by rectal examination; note the lack of lateral rectal wall support. (Reproduced from the )
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8.27
(a) Semitendinosus muscle being dissected prior to distal transection and used to repair a ventral perineal hernia. (b) Semitendinosus muscle being sutured in ventral portion of hernia. © 2015 British Small Animal Veterinary Association
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8.27 (a) Semitendinosus muscle being dissected prior to distal transection and used to repair a ventral perineal hernia. (b) Semitendinosus muscle being sutured in ventral portion of hernia.
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8.28
Rectocutaneous fistula. © 2015 British Small Animal Veterinary Association
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8.28 Rectocutaneous fistula.
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8.29
Omentalization of the perineal wound in Figure 8.28 . © 2015 British Small Animal Veterinary Association
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8.29 Omentalization of the perineal wound in Figure 8.28 .
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Colonic biopsy. A stay suture is placed through one side of the incision and a second incision is made with fine Metzenbaum scissors to form an ellipse around the stay suture.
Colonic biopsy. A stay suture is placed through one side of the incision and a second incision is made with fine Metzenbaum scissors to form an ellipse around the stay suture. © 2015 British Small Animal Veterinary Association
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Image of Colonic biopsy. A stay suture is placed through one side of the incision and a second incision is made with fine Metzenbaum scissors to form an ellipse around the stay suture.
Colonic biopsy. A stay suture is placed through one side of the incision and a second incision is made with fine Metzenbaum scissors to form an ellipse around the stay suture. Colonic biopsy. A stay suture is placed through one side of the incision and a second incision is made with fine Metzenbaum scissors to form an ellipse around the stay suture.
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Closure of a colostomy incision with a simple continuous suture pattern. Note: all sutures penetrate the submucosa.
Closure of a colostomy incision with a simple continuous suture pattern. Note: all sutures penetrate the submucosa. © 2015 British Small Animal Veterinary Association
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Image of Closure of a colostomy incision with a simple continuous suture pattern. Note: all sutures penetrate the submucosa.
Closure of a colostomy incision with a simple continuous suture pattern. Note: all sutures penetrate the submucosa. Closure of a colostomy incision with a simple continuous suture pattern. Note: all sutures penetrate the submucosa.
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Subtotal colectomy is performed after identifying the proximal (A or B) and distal (C) resection sites and ligating the appropriate blood vessels (blue crosses). If the ileocolic valve is to be removed, the ileocolic artery and vein need to be ligated (arrowed).
Subtotal colectomy is performed after identifying the proximal (A or B) and distal (C) resection sites and ligating the appropriate blood vessels (blue crosses). If the ileocolic valve is to be removed, the ileocolic artery and vein need to be ligated (arrowed). © 2015 British Small Animal Veterinary Association
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Image of Subtotal colectomy is performed after identifying the proximal (A or B) and distal (C) resection sites and ligating the appropriate blood vessels (blue crosses). If the ileocolic valve is to be removed, the ileocolic artery and vein need to be ligated (arrowed).
Subtotal colectomy is performed after identifying the proximal (A or B) and distal (C) resection sites and ligating the appropriate blood vessels (blue crosses). If the ileocolic valve is to be removed, the ileocolic artery and vein need to be ligated (arrowed). Subtotal colectomy is performed after identifying the proximal (A or B) and distal (C) resection sites and ligating the appropriate blood vessels (blue crosses). If the ileocolic valve is to be removed, the ileocolic artery and vein need to be ligated (arrowed).
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The ileocaecal fold is dissected and branches of the ileocaecal artery supplying the caecum are ligated.
The ileocaecal fold is dissected and branches of the ileocaecal artery supplying the caecum are ligated. © 2015 British Small Animal Veterinary Association
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Image of The ileocaecal fold is dissected and branches of the ileocaecal artery supplying the caecum are ligated.
The ileocaecal fold is dissected and branches of the ileocaecal artery supplying the caecum are ligated. The ileocaecal fold is dissected and branches of the ileocaecal artery supplying the caecum are ligated.
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Two non-crushing intestinal clamps are placed across the base of the caecum and it is amputated between the two forceps.
Two non-crushing intestinal clamps are placed across the base of the caecum and it is amputated between the two forceps. © 2015 British Small Animal Veterinary Association
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Image of Two non-crushing intestinal clamps are placed across the base of the caecum and it is amputated between the two forceps.
Two non-crushing intestinal clamps are placed across the base of the caecum and it is amputated between the two forceps. Two non-crushing intestinal clamps are placed across the base of the caecum and it is amputated between the two forceps.
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The base of the caecum is then oversewn with synthetic absorbable suture material using a Parker–Kerr suture pattern.
The base of the caecum is then oversewn with synthetic absorbable suture material using a Parker–Kerr suture pattern. © 2015 British Small Animal Veterinary Association
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Image of The base of the caecum is then oversewn with synthetic absorbable suture material using a Parker–Kerr suture pattern.
The base of the caecum is then oversewn with synthetic absorbable suture material using a Parker–Kerr suture pattern. The base of the caecum is then oversewn with synthetic absorbable suture material using a Parker–Kerr suture pattern.
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TA stapling device being used to resect a perforated caecal mass in a 10-year-old Greyhound bitch. Histopathology revealed the mass to be a leiomyosarcoma.
TA stapling device being used to resect a perforated caecal mass in a 10-year-old Greyhound bitch. Histopathology revealed the mass to be a leiomyosarcoma. © 2015 British Small Animal Veterinary Association
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Image of TA stapling device being used to resect a perforated caecal mass in a 10-year-old Greyhound bitch. Histopathology revealed the mass to be a leiomyosarcoma.
TA stapling device being used to resect a perforated caecal mass in a 10-year-old Greyhound bitch. Histopathology revealed the mass to be a leiomyosarcoma. TA stapling device being used to resect a perforated caecal mass in a 10-year-old Greyhound bitch. Histopathology revealed the mass to be a leiomyosarcoma.
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Incisional colopexy. Gentle cranial traction is applied to the descending colon.
Incisional colopexy. Gentle cranial traction is applied to the descending colon. © 2015 British Small Animal Veterinary Association
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Image of Incisional colopexy. Gentle cranial traction is applied to the descending colon.
Incisional colopexy. Gentle cranial traction is applied to the descending colon. Incisional colopexy. Gentle cranial traction is applied to the descending colon.
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Incisions of similar length are made in the peritoneum of the left abdominal wall and through the seromuscular layer of the descending colon.
Incisions of similar length are made in the peritoneum of the left abdominal wall and through the seromuscular layer of the descending colon. © 2015 British Small Animal Veterinary Association
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Image of Incisions of similar length are made in the peritoneum of the left abdominal wall and through the seromuscular layer of the descending colon.
Incisions of similar length are made in the peritoneum of the left abdominal wall and through the seromuscular layer of the descending colon. Incisions of similar length are made in the peritoneum of the left abdominal wall and through the seromuscular layer of the descending colon.
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The colon is sutured to the abdominal wall using a simple continuous suture pattern, starting with the deepest side of the incision.
The colon is sutured to the abdominal wall using a simple continuous suture pattern, starting with the deepest side of the incision. © 2015 British Small Animal Veterinary Association
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Image of The colon is sutured to the abdominal wall using a simple continuous suture pattern, starting with the deepest side of the incision.
The colon is sutured to the abdominal wall using a simple continuous suture pattern, starting with the deepest side of the incision. The colon is sutured to the abdominal wall using a simple continuous suture pattern, starting with the deepest side of the incision.
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The superficial side of the incision is sutured similarly to complete the colopexy.
The superficial side of the incision is sutured similarly to complete the colopexy. © 2015 British Small Animal Veterinary Association
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Image of The superficial side of the incision is sutured similarly to complete the colopexy.
The superficial side of the incision is sutured similarly to complete the colopexy. The superficial side of the incision is sutured similarly to complete the colopexy.
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Anal ‘pull-out’ procedure for annular lesions.
Anal ‘pull-out’ procedure for annular lesions. © 2015 British Small Animal Veterinary Association
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Image of Anal ‘pull-out’ procedure for annular lesions.
Anal ‘pull-out’ procedure for annular lesions. Anal ‘pull-out’ procedure for annular lesions.
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The skin incision is made with care to avoid the anal sacs and their ducts.
The skin incision is made with care to avoid the anal sacs and their ducts. © 2015 British Small Animal Veterinary Association
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Image of The skin incision is made with care to avoid the anal sacs and their ducts.
The skin incision is made with care to avoid the anal sacs and their ducts. The skin incision is made with care to avoid the anal sacs and their ducts.
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A combination of sharp and blunt dissection is carried out to free the rectum from the external anal sphincter muscle.
A combination of sharp and blunt dissection is carried out to free the rectum from the external anal sphincter muscle. © 2015 British Small Animal Veterinary Association
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Image of A combination of sharp and blunt dissection is carried out to free the rectum from the external anal sphincter muscle.
A combination of sharp and blunt dissection is carried out to free the rectum from the external anal sphincter muscle. A combination of sharp and blunt dissection is carried out to free the rectum from the external anal sphincter muscle.
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The rectum is excised 1–2 cm proximal to the lesion.
The rectum is excised 1–2 cm proximal to the lesion. © 2015 British Small Animal Veterinary Association
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Image of The rectum is excised 1–2 cm proximal to the lesion.
The rectum is excised 1–2 cm proximal to the lesion. The rectum is excised 1–2 cm proximal to the lesion.
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The rectum is sutured to the skin using absorbable suture material in a simple interrupted pattern.
The rectum is sutured to the skin using absorbable suture material in a simple interrupted pattern. © 2015 British Small Animal Veterinary Association
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Image of The rectum is sutured to the skin using absorbable suture material in a simple interrupted pattern.
The rectum is sutured to the skin using absorbable suture material in a simple interrupted pattern. The rectum is sutured to the skin using absorbable suture material in a simple interrupted pattern.
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A horseshoe-shaped incision is made dorsal to the anus.
A horseshoe-shaped incision is made dorsal to the anus. © 2015 British Small Animal Veterinary Association
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Image of A horseshoe-shaped incision is made dorsal to the anus.
A horseshoe-shaped incision is made dorsal to the anus. A horseshoe-shaped incision is made dorsal to the anus.
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Muscles exposed via the dorsal approach.
Muscles exposed via the dorsal approach. © 2015 British Small Animal Veterinary Association
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Image of Muscles exposed via the dorsal approach.
Muscles exposed via the dorsal approach. Muscles exposed via the dorsal approach.
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The rectum and lesion are identified and the area to be excised planned.
The rectum and lesion are identified and the area to be excised planned. © 2015 British Small Animal Veterinary Association
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Image of The rectum and lesion are identified and the area to be excised planned.
The rectum and lesion are identified and the area to be excised planned. The rectum and lesion are identified and the area to be excised planned.
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Stay sutures are used to reduce the risk of retraction of the severed ends of the rectum.
Stay sutures are used to reduce the risk of retraction of the severed ends of the rectum. © 2015 British Small Animal Veterinary Association
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Image of Stay sutures are used to reduce the risk of retraction of the severed ends of the rectum.
Stay sutures are used to reduce the risk of retraction of the severed ends of the rectum. Stay sutures are used to reduce the risk of retraction of the severed ends of the rectum.
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The rectum is anastomosed using monofilament absorbable suture material.
The rectum is anastomosed using monofilament absorbable suture material. © 2015 British Small Animal Veterinary Association
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Image of The rectum is anastomosed using monofilament absorbable suture material.
The rectum is anastomosed using monofilament absorbable suture material. The rectum is anastomosed using monofilament absorbable suture material.
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Pelvic symphysiotomy. Symphysiotomy/osteotomy sites.
Pelvic symphysiotomy. Symphysiotomy/osteotomy sites. © 2015 British Small Animal Veterinary Association
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Image of Pelvic symphysiotomy. Symphysiotomy/osteotomy sites.
Pelvic symphysiotomy. Symphysiotomy/osteotomy sites. Pelvic symphysiotomy. Symphysiotomy/osteotomy sites.
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Use of a rib retractor, such as a Finochietto retractor, helps to improve exposure.
Use of a rib retractor, such as a Finochietto retractor, helps to improve exposure. © 2015 British Small Animal Veterinary Association
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Image of Use of a rib retractor, such as a Finochietto retractor, helps to improve exposure.
Use of a rib retractor, such as a Finochietto retractor, helps to improve exposure. Use of a rib retractor, such as a Finochietto retractor, helps to improve exposure.
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Following resection of the rectal lesion, a routine anastomosis is carried out.
Following resection of the rectal lesion, a routine anastomosis is carried out. © 2015 British Small Animal Veterinary Association
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Image of Following resection of the rectal lesion, a routine anastomosis is carried out.
Following resection of the rectal lesion, a routine anastomosis is carried out. Following resection of the rectal lesion, a routine anastomosis is carried out.
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The symphysis or osteotomy is repaired with orthopaedic wire passed through pre-drilled holes.
The symphysis or osteotomy is repaired with orthopaedic wire passed through pre-drilled holes. © 2015 British Small Animal Veterinary Association
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Image of The symphysis or osteotomy is repaired with orthopaedic wire passed through pre-drilled holes.
The symphysis or osteotomy is repaired with orthopaedic wire passed through pre-drilled holes. The symphysis or osteotomy is repaired with orthopaedic wire passed through pre-drilled holes.
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Incision from the base of the tail to the ischial tuberosity.
Incision from the base of the tail to the ischial tuberosity. © 2015 British Small Animal Veterinary Association
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Image of Incision from the base of the tail to the ischial tuberosity.
Incision from the base of the tail to the ischial tuberosity. Incision from the base of the tail to the ischial tuberosity.
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Ultrasound scan of a perineal prostatic cyst.
Ultrasound scan of a perineal prostatic cyst. © 2015 British Small Animal Veterinary Association
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Image of Ultrasound scan of a perineal prostatic cyst.
Ultrasound scan of a perineal prostatic cyst. Ultrasound scan of a perineal prostatic cyst.
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Perineal prostatic cyst at surgery.
Perineal prostatic cyst at surgery. © 2015 British Small Animal Veterinary Association
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Image of Perineal prostatic cyst at surgery.
Perineal prostatic cyst at surgery. Perineal prostatic cyst at surgery.
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Perineal anatomy in a dog without a perineal hernia. (Courtesy of M McLoughlin)
Perineal anatomy in a dog without a perineal hernia. (Courtesy of M McLoughlin) © 2015 British Small Animal Veterinary Association
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Image of Perineal anatomy in a dog without a perineal hernia. (Courtesy of M McLoughlin)
Perineal anatomy in a dog without a perineal hernia. (Courtesy of M McLoughlin) Perineal anatomy in a dog without a perineal hernia. (Courtesy of M McLoughlin)
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Elevation of the internal obturator muscle (IOM). EASM = external anal sphincter muscle.
Elevation of the internal obturator muscle (IOM). EASM = external anal sphincter muscle. © 2015 British Small Animal Veterinary Association
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Image of Elevation of the internal obturator muscle (IOM). EASM = external anal sphincter muscle.
Elevation of the internal obturator muscle (IOM). EASM = external anal sphincter muscle. Elevation of the internal obturator muscle (IOM). EASM = external anal sphincter muscle.
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Elevation of internal obturator muscle using a periosteal elevator. (Courtesy of M McLoughlin)
Elevation of internal obturator muscle using a periosteal elevator. (Courtesy of M McLoughlin) © 2015 British Small Animal Veterinary Association
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Image of Elevation of internal obturator muscle using a periosteal elevator. (Courtesy of M McLoughlin)
Elevation of internal obturator muscle using a periosteal elevator. (Courtesy of M McLoughlin) Elevation of internal obturator muscle using a periosteal elevator. (Courtesy of M McLoughlin)
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The internal obturator muscle has been elevated. Note that the internal obturator tendon has been transected (arrowed). (Courtesy of M McLoughlin)
The internal obturator muscle has been elevated. Note that the internal obturator tendon has been transected (arrowed). (Courtesy of M McLoughlin) © 2015 British Small Animal Veterinary Association
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Image of The internal obturator muscle has been elevated. Note that the internal obturator tendon has been transected (arrowed). (Courtesy of M McLoughlin)
The internal obturator muscle has been elevated. Note that the internal obturator tendon has been transected (arrowed). (Courtesy of M McLoughlin) The internal obturator muscle has been elevated. Note that the internal obturator tendon has been transected (arrowed). (Courtesy of M McLoughlin)
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Surgical anatomy of a perineal hernia; note suture placement. EASM = external anal sphincter muscle; IOM = internal obturator muscle.
Surgical anatomy of a perineal hernia; note suture placement. EASM = external anal sphincter muscle; IOM = internal obturator muscle. © 2015 British Small Animal Veterinary Association
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Image of Surgical anatomy of a perineal hernia; note suture placement. EASM = external anal sphincter muscle; IOM = internal obturator muscle.
Surgical anatomy of a perineal hernia; note suture placement. EASM = external anal sphincter muscle; IOM = internal obturator muscle. Surgical anatomy of a perineal hernia; note suture placement. EASM = external anal sphincter muscle; IOM = internal obturator muscle.
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Polypropylene sutures have been pre-placed between: the levator ani/coccygeus and the external anal sphincter muscles; the levator ani/coccygeus and the internal obturator muscles; and the internal obturator and external anal sphincter muscles. (Courtesy of M McLoughlin)
Polypropylene sutures have been pre-placed between: the levator ani/coccygeus and the external anal sphincter muscles; the levator ani/coccygeus and the internal obturator muscles; and the internal obturator and external anal sphincter muscles. (Courtesy of M McLoughlin) © 2015 British Small Animal Veterinary Association
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Image of Polypropylene sutures have been pre-placed between: the levator ani/coccygeus and the external anal sphincter muscles; the levator ani/coccygeus and the internal obturator muscles; and the internal obturator and external anal sphincter muscles. (Courtesy of M McLoughlin)
Polypropylene sutures have been pre-placed between: the levator ani/coccygeus and the external anal sphincter muscles; the levator ani/coccygeus and the internal obturator muscles; and the internal obturator and external anal sphincter muscles. (Courtesy of M McLoughlin) Polypropylene sutures have been pre-placed between: the levator ani/coccygeus and the external anal sphincter muscles; the levator ani/coccygeus and the internal obturator muscles; and the internal obturator and external anal sphincter muscles. (Courtesy of M McLoughlin)
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Fine mosquito forceps or a sterile probe is placed within the duct of the anal sac.
Fine mosquito forceps or a sterile probe is placed within the duct of the anal sac. © 2015 British Small Animal Veterinary Association
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Image of Fine mosquito forceps or a sterile probe is placed within the duct of the anal sac.
Fine mosquito forceps or a sterile probe is placed within the duct of the anal sac. Fine mosquito forceps or a sterile probe is placed within the duct of the anal sac.
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Incise on to the probe with a No. 15 scalpel blade; the incision is extended into the anal sac.
Incise on to the probe with a No. 15 scalpel blade; the incision is extended into the anal sac. © 2015 British Small Animal Veterinary Association
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Image of Incise on to the probe with a No. 15 scalpel blade; the incision is extended into the anal sac.
Incise on to the probe with a No. 15 scalpel blade; the incision is extended into the anal sac. Incise on to the probe with a No. 15 scalpel blade; the incision is extended into the anal sac.
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The anal sac is dissected free and amputated at the level of the duct opening.
The anal sac is dissected free and amputated at the level of the duct opening. © 2015 British Small Animal Veterinary Association
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Image of The anal sac is dissected free and amputated at the level of the duct opening.
The anal sac is dissected free and amputated at the level of the duct opening. The anal sac is dissected free and amputated at the level of the duct opening.
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The defect is closed routinely with absorbable sutures subcutaneously and monofilament nylon in the skin.
The defect is closed routinely with absorbable sutures subcutaneously and monofilament nylon in the skin. © 2015 British Small Animal Veterinary Association
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Image of The defect is closed routinely with absorbable sutures subcutaneously and monofilament nylon in the skin.
The defect is closed routinely with absorbable sutures subcutaneously and monofilament nylon in the skin. The defect is closed routinely with absorbable sutures subcutaneously and monofilament nylon in the skin.
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A 9-year-old male crossbreed dog with mild perianal fistulae.
A 9-year-old male crossbreed dog with mild perianal fistulae. © 2015 British Small Animal Veterinary Association
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Image of A 9-year-old male crossbreed dog with mild perianal fistulae.
A 9-year-old male crossbreed dog with mild perianal fistulae. A 9-year-old male crossbreed dog with mild perianal fistulae.
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A 360-degree incision is made around the anus, incorporating all fistulous tracts.
A 360-degree incision is made around the anus, incorporating all fistulous tracts. © 2015 British Small Animal Veterinary Association
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Image of A 360-degree incision is made around the anus, incorporating all fistulous tracts.
A 360-degree incision is made around the anus, incorporating all fistulous tracts. A 360-degree incision is made around the anus, incorporating all fistulous tracts.
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Anal sacculectomy being performed owing to secondary involvement of the anal sacs in a German Shepherd Dog with severe perianal fistulae. Note that a surgical probe has been placed into the anal sac.
Anal sacculectomy being performed owing to secondary involvement of the anal sacs in a German Shepherd Dog with severe perianal fistulae. Note that a surgical probe has been placed into the anal sac. © 2015 British Small Animal Veterinary Association
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Image of Anal sacculectomy being performed owing to secondary involvement of the anal sacs in a German Shepherd Dog with severe perianal fistulae. Note that a surgical probe has been placed into the anal sac.
Anal sacculectomy being performed owing to secondary involvement of the anal sacs in a German Shepherd Dog with severe perianal fistulae. Note that a surgical probe has been placed into the anal sac. Anal sacculectomy being performed owing to secondary involvement of the anal sacs in a German Shepherd Dog with severe perianal fistulae. Note that a surgical probe has been placed into the anal sac.
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The diseased tissue (including the anus) is dissected free. The external anal sphincter muscle (EASM) should be preserved if possible.
The diseased tissue (including the anus) is dissected free. The external anal sphincter muscle (EASM) should be preserved if possible. © 2015 British Small Animal Veterinary Association
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Image of The diseased tissue (including the anus) is dissected free. The external anal sphincter muscle (EASM) should be preserved if possible.
The diseased tissue (including the anus) is dissected free. The external anal sphincter muscle (EASM) should be preserved if possible. The diseased tissue (including the anus) is dissected free. The external anal sphincter muscle (EASM) should be preserved if possible.
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The rectum and anus are amputated.
The rectum and anus are amputated. © 2015 British Small Animal Veterinary Association
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Image of The rectum and anus are amputated.
The rectum and anus are amputated. The rectum and anus are amputated.
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The rectum is sutured to the skin with absorbable monofilament suture material.
The rectum is sutured to the skin with absorbable monofilament suture material. © 2015 British Small Animal Veterinary Association
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Image of The rectum is sutured to the skin with absorbable monofilament suture material.
The rectum is sutured to the skin with absorbable monofilament suture material. The rectum is sutured to the skin with absorbable monofilament suture material.
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Following excision of all diseased tissue the anus has been reconstructed by closing the skin defect and suturing the rectal mucosa to the skin.
Following excision of all diseased tissue the anus has been reconstructed by closing the skin defect and suturing the rectal mucosa to the skin. © 2015 British Small Animal Veterinary Association
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Image of Following excision of all diseased tissue the anus has been reconstructed by closing the skin defect and suturing the rectal mucosa to the skin.
Following excision of all diseased tissue the anus has been reconstructed by closing the skin defect and suturing the rectal mucosa to the skin. Following excision of all diseased tissue the anus has been reconstructed by closing the skin defect and suturing the rectal mucosa to the skin.
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