Emergency Surgery of the Gastrointestinal Tract

Emergency gastrointestinal surgery presents the clinician with several challenges. Animals may present with severe dehydration and cardiovascular instability secondary to frequent vomiting, fluid sequestration in the bowel, or bowel perforation causing peritonitis and sepsis. Vomiting or regurgitation may result in aspiration pneumonia. During initial resuscitation, the clinician must determine the nature of the problem and decide if surgery is indicated. The animal must be as stable as possible before anesthesia. However, it is important to realize that complete stabilization of the animal may not be possible until the underlying disease (for example, peritonitis) is addressed. Anesthetic agents with minimal depressant effects on the cardiovascular and respiratory systems are used. The entire ventral abdomen and caudal thorax are clipped and prepared for aseptic surgery. Broad spectrum, bacteriocidal antibiotics are administered if bacterial contamination of the peritoneal cavity is suspected or anticipated. A large incision is made, extending from the xiphoid caudally past the umbilicus. A complete exploratory laparotomy is performed and all organ systems examined sequentially. Definitive treatment depends on the organ system affected and the nature of the disease. [....]