The Pathophysiology of Small Intestinal Foreign Body Obstruction and Intraoperative Assessment of Tissue Viability in Dogs: A Review

• Published in: Topics in companion animal medicine Vol. 40; p. 100438
• Main Authors: Mullen, Kaitlyn M., Regier, Penny J., Ellison, Gary W., Londoño, Leonel
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2020; Elsevier Limited
• Subjects: Anastomosis; Animals; Bile; Bleeding; canine intestine; Carbohydrates; Decision making; Dog Diseases - physiopathology; Dog Diseases - surgery; Dogs; Electrolytes; Enzymes; Foreign bodies; Foreign Bodies - diagnostic imaging; Foreign Bodies - physiopathology; Foreign Bodies - surgery; Foreign Bodies - veterinary; foreign body obstruction; Gallbladder; Hydrochloric acid; Inflammation; Inflammatory response; Intestinal motility; Intestinal obstruction; Intestinal Obstruction - diagnostic imaging; Intestinal Obstruction - physiopathology; Intestinal Obstruction - surgery; Intestinal Obstruction - veterinary; intestinal tissue; Intestine; Intestine, Small - pathology; Intestine, Small - surgery; Lipids; Morbidity; Mortality; Nervous system; Obstructions; Pathophysiology; Peristalsis; Proteins; Radiography, Abdominal; Sepsis; Small intestine; Surgeons; Surgery; Surgical equipment; Tissue Survival; tissue viability; Ultrasonography - veterinary; Vomiting; intestinal obstruction; PBR; RBCW; IL; canine intestine; MMPs; SpO2; CCK; Median P50; foreign body obstruction; R&A; TNF; PAMP; SIRS; RBC; SDF; MODS; SaO2; tissue viability; intestinal tissue; DAMP; Dperf
• ISSN: 1938-9736; 1946-9837; 1876-7613
• DOI: 10.1016/j.tcam.2020.100438

Small intestinal foreign body obstructions occur commonly in dogs, accounting for 80% of all canine intestinal obstructions. Such obstructions induce local aberrations in secretion, absorption, and intestinal motility that can precipitate devastating systemic consequences, including a systemic inflammatory response, sepsis, and multiorgan dysfunction. Radiographic diagnosis is poorly sensitive relative to ultrasonography for diagnosing the presence of obstructive foreign material. Emergent surgical intervention is indicated for dogs with obstructive foreign material due to an inability to assess the degree of compromise of the intestinal wall that may precipitate intestinal perforation and to mitigate progression of life-threatening electrolyte and acid-base imbalances secondary to sequestration and emesis. Intraoperatively, an enterotomy or resection and anastomosis may be required to remove the obstructive material. A number of subjective and objective techniques for assessing the viability of intestinal tissue have been described due to the poor accuracy associated with surgeon assessment of color, peristalsis, pulsation, bleeding, and mural thickness alone. Such techniques have the potential to alter the surgeon's decision-making regarding performance of an enterotomy or resection and anastomosis, potentially reducing morbidity associated with intestinal surgery.