Assessment of two methods of gastric decompression for the initial management of gastric dilatation‐volvulus

Abstract

Objective To assess gastric trocarization and orogastric tubing as a means of gastric decompression for the initial management of gastric dilatation‐volvulus. Methods Retrospective review of 116 gastric dilatation‐volvulus cases from June 2001 to October 2009. Results Decompression was performed via orogastric tubing in 31 dogs, gastric trocarization in 39 dogs and a combination of both in 46 dogs. Tubing was successful in 59 (75·5%) dogs and unsuccessful in 18 (23·4%) dogs. Trocarization was successful in 73 (86%) dogs and unsuccessful in 12 (14%) dogs. No evidence of gastric perforation was noted at surgery in dogs undergoing either technique. One dog that underwent trocarization had a splenic laceration identified at surgery that did not require treatment. Oesophageal rupture or aspiration pneumonia was not identified in any dog during hospitalization. No statistical difference was found between the method of gastric decompression and gastric compromise requiring surgical intervention or survival to discharge. Clinical Significance Orogastric tubing and gastric trocarization are associated with low complication and high success rates. Either technique is an acceptable method for gastric decompression in dogs with gastric dilatation‐volvulus.

Reporte de caso: dilatación vólvulo gástrico y peritonitis biliar en un canino de 5 meses

“…En cuanto a las técnicas de descompresión, existen estudios que evidencian que no existe diferencia significativa entre la supervivencia con sondaje orogástrico y con trocarización percutánea (Goodrich et al, 2013); sin embargo, el sondaje otorga la ventaja de permitir la expulsión del contenido líquido y sólido mientras que la trocarización facilita la evacuación de gas, disminuyendo la presión intragástrica, que puede llegar a impedir el sondaje.…”

Outcomes of dogs undergoing surgery for gastric dilatation volvulus after rapid versus prolonged medical stabilization

“…This finding could be explained by preoperative resolution of volvulus, reported after gastric decompression with placement of an orogastric tube alone, trocarization alone, or a combination of both. 15,25 However, spontaneous resolution of gastric torsion after gastric decompression and lavage can lead to recurrence of gastric volvulus. 15 This highlights the importance of continued close monitoring of patients allocated to a delayed protocol.…”

“…During delayed surgeries, GDVs were found to include more 0° degree and fewer 180° and 270° torsions than during immediate interventions ( P = .05). This finding could be explained by preoperative resolution of volvulus, reported after gastric decompression with placement of an orogastric tube alone, trocarization alone, or a combination of both 15,25 . However, spontaneous resolution of gastric torsion after gastric decompression and lavage can lead to recurrence of gastric volvulus 15 .…”

“…This highlights the importance of continued close monitoring of patients allocated to a delayed protocol. Trocarization seems advantageous in comparison with orogastric tubing as this technique does not require sedation of hemodynamically unstable dogs 25 . However, a nasogastric or orogastric tube should be maintained preoperatively if surgery is delayed, to prevent recurrence of gastric distention.…”

Food engorgement in 35 dogs (2009–2013) compared with 36 dogs with gastric dilation and volvulus

“…In contrast to FE, gastric dilation and volvulus (GDV) is a life-threatening emergency where the need for timely gastric decompression has been well established. 3 Prompt treatment of impaired systemic perfusion created by GDV is recognised as a vital component of stabilisation. In particular, increased blood lactate concentration is associated with gastric necrosis in dogs with G DV.…”