Gastrointestinal Emergencies

Abstract

The animal with a surgical gastrointestinal emergency usually requires a rapid, thorough physical examination with concurrent resuscitation. As the diagnosis is being made, the animal must be made as stable as possible before undergoing general anesthesia. During surgery, there must be a critical evaluation of gastrointestinal viability and the use of precise technical skills to achieve the best outcome. Adept postoperative management, including careful monitoring and an index of suspicion for potential complications, is vital.

Gastric Dilatation-Volvulus Syndrome: Outcome and Factors Associated with Perioperative Mortality

“…Dogs with GDV arriving at the clinic within three hours from the onset of clinical signs had a nine times lower mortality rate than those arriving after eleven and more hours. Our study thus confirms the general recommendation to treat such patients as soon as possible after the onset of clinical signs (Aronson et al 2000;Strombeck and Guilford 1990). Previous studies, however, did not strictly determine the time period from the onset of clinical signs until presentation as a significant risk factor (Glickman et al 1998;Van Sluijs 1991;Brockman et al 1995).…”

“…Another possible explanation is that some cases presented in this study had a relatively long time period from the onset of clinical signs until presentation at the clinic. Most authors share the opinion that in the GDV syndrome, gastric dilatation occurs as a primary event, whereas volvulus occurs secondarily (Matthiesen 1993;Aronson et al 2000). The longer time lapsed from the onset of clinical signs until arrival at the clinic could thus be responsible for the change from simple dilatation to secondary volvulus of the presented case.…”

“…1) immediate and aggressive patient stabilisation including gastric decompression and treatment of shock; 2) surgical correction of volvulus including gastropexy to prevent recurrence; and 3) post-operative monitoring and intensive care (Matthiesen 1983;Aronson et al…”

“…Various studies report mortality varying from 10 to 60% (Betts et al 1974;Muir 1982;Walshaw and Johnson 1976;Matthiesen 1983;Frankquist and Obel 1979; Winfgield et al 1975;Glickman et al 1994;Brockman et al 1995;Brourman 1996;Van Sluijs 1991;Glickman et al 1998;Eggertsdóttir and Moe 1995;Nagel and Neumann 1992). It is, however, difficult to compare individual results because of differences in the definition of mortality and different therapeutic procedures within individual studies.On the basis of our current knowledge, therapy of the syndrome consists of three important parts:1) immediate and aggressive patient stabilisation including gastric decompression and treatment of shock; 2) surgical correction of volvulus including gastropexy to prevent recurrence; and 3) post-operative monitoring and intensive care (Matthiesen 1983;Aronson et al …”

Clinical results and complications of preventive laparoscopic assisted gastropexy in 17 dogs: preliminary study

“…Gastric dilatation-volvulus (GDV) is a life threatening disease and its mortality ranges from 10 to 60% (Aronson et al 2000). GDV is the second most frequently stated cause of death in large breeds of dogs (Glickman et al 1994(Glickman et al , 2000.…”