Mortality rate comparison of enterotomy and resection and anastomosis (enterectomy) in dogs with foreign-body obstructions

PICO question In dogs with gastrointestinal foreign-body obstruction undergoing surgical correction, is the mortality rate in the perioperative period for those receiving resection and anastomosis higher, lower, or equivalent to those receiving an enterotomy? Clinical bottom line Category of research question Outcome The number and type of study designs reviewed Four retrospective studies were reviewed Strength of evidence Weak Outcomes reported It would appear that the mortality rate for resection and anastomosis for the purpose of foreign-body removal is higher than that of enterotomies performed for the same reason Conclusion There is insufficient evidence directly comparing enterotomies with resection and anastomoses in foreign-body obstructions to definitively state that the mortality rate is higher among resection and anastomosis procedures How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.

Imaging characteristics and mechanism of negative pressure pulmonary edema in children: three case reports

This article reports three children who presented with negative pressure pulmonary oedema before or after removal of the airway foreign bodies. Of them, two cases were type I negative pressure pulmonary oedema and one case was type II negative pressure pulmonary oedema following foreign body removal from the airways. Pathogenesis and location differences between type I and type II negative pressure pulmonary oedema caused by airway foreign body obstruction, as well as diagnosis and treatment modalities of the negative pressure pulmonary oedema were discussed.

Surgical Procedure among Patients with Foreign Body Obstruction in Food Passage in a Tertiary Care Hospital: A Descriptive Cross-sectional Study

Introduction: Foreign body is any object in a region it is not meant to be, where it can cause harm if immediate medical attention is not sought. Its removal by surgical procedure is one of the commonest surgeries done. The objective is to find out prevalence of the patients who underwent operation for foreign bodies obstruction in food passage in the Department of Otorhinolaryngology-Head and Neck Surgery in a tertiary care centre. Methods: A descriptive cross-sectional study conducted among patients operated in the Department of Otorhinolaryngology and Head and Neck Surgery of a tertiary care center from August 2014 to May 2017. Ethical approval was received from the Institutional Review Committee of the Institute. Convenience sampling method was used. Statistical Package for the Social Sciences was used for analysis. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Out of total 700 patients having operation in department, 115 (16.42%) (95% Confidence Interval = 13.67–19.16) had operation for foreign body obstruction in the food passage. Among 115 patients, 62 (53.90%) were males and 53 (46.10%) were females. Most common foreign bodies ingested in children was coin 17 (14.78%) and bone chips 40 (34.78%) in adults. Cricopharynx 90 (78.26%) is the commonest site for foreign body lodgement. Conclusions: Prevalence of the patients who underwent operation for foreign bodies obstruction in food passage in a tertiary care hospital is high. Their removal by rigid oesophagoscopy is one of the commonest surgical procedures done in tertiary care center.

Fatal multiple intestinal intussusceptions and torsion secondary to a non-degradable foreign body gastrointestinal obstruction in a captive Lion (Panthera leo)

Intussusception is the invagination of one segment of the intestine into the part of the tract that either precedes or follows in the gastrointestinal tract of different species of animals. This report describes a case of fatal multiple intestinal intussusceptions and torsion associated with non-degradable foreign body gastrointestinal obstruction in a captive lion (Panthera leo) in a zoo in Nigeria. Parenchymatous tissues were aseptically collected during necropsy for bacteriological isolation and histopathology. Also, intestinal fecal material was collected and sent for parasitological examination. The main lesions were gastroduodenal, duodeduodenal, duodejejunal and jejunojenunal intussusceptions and duodenal torsion. A non-degradable towel-like fabric foreign body obstruction along the pyloric antrum/canal region of the stomach down to the jejunum was found. Microscopic lesion included ischemic necrosis of inner circular and outer longitudinal smooth muscles of the intestine with necrosis of other layers and vascular congestion. Parasitological examination revealed presence of Babesia spp. in blood smear examined before the death of the lion. While Escherichia coli was isolated from the liver on MacConkey agar. A diagnosis of intussusception and torsion associated with non-degradable foreign body (fabric) gastrointestinal obstruction was made. This first case of ingestion of a non-degradable fabric foreign body leading to gastrointestinal obstruction in captive lion in Nigeria has brought about the need for vigilance of zoo authority to prevent a recurrence during crowd influx to the garden.

Conservative surgical management of a supernumerary tooth in the nasal cavity

A 9-year-old girl presented with a foreign body obstruction inside her nose. The condition led to pain and nasal congestion. CT showed the presence of a radiopaque mass similar to a tooth in the right nasal cavity. Diagnosis of a supernumerary intranasal tooth was made and extraction was performed under general anaesthesia. An ectopic tooth in the nasal cavity is rare and surgical removal is recommended to eliminate the symptoms.

Grass as a linear gastrointestinal foreign body obstruction in four dogs

Four dogs presented with linear gastrointestinal foreign body (FB) obstruction caused by impacted grass fibres. The material had become anchored within the pylorus in three dogs, causing necrosis and perforation of the mesenteric border of the affected intestinal segment. Gastrotomy and intestinal resection and anastomosis were performed. The fourth case presented acutely with no intestinal necrosis or perforation, with the fibres removed via enterotomy. One dog suffered severe postoperative ileus that failed to respond to medical management. Continued deterioration prompted euthanasia 12 days postoperatively. The other three dogs survived and were discharged without complication. Grass has not previously been reported as a cause of linear gastrointestinal obstruction in dogs. It has, however, the potential to cause severe necrosis and perforation of the intestine and should be recognised as a potential linear FB in dogs.