- Abdominal exploration is a diagnostic and sometimes therapeutic procedure.

- Vomiting is the first sign in a variety of diseases affecting the digestive tract.

- Once the procedure is complete, intensive care is required to ensure optimal recovery.

Introduction

  • Stomach and intestinal surgery is common. The reasons for intervention on the digestive tract include ingestion of foreign bodies, tumors, intestinal torsion, intestussusception, dilation, and intestinal biopsies. Various diagnostic tests are performed beforehand to determine the nature of the problem.
  • First, a blood test is performed to determine whether liver, kidney, pancreatic or electrolyte abnormalities. A blood count is taken to look for signs of infection or anemia. X-ray images can be very useful to indicate the existence of a digestive problem. However, they do not give a definitive diagnosis and abdominal ultrasound or contrast x-rays may be necessary.
  • Sometimes these examinations do not allow to conclude on the nature of the problem and an exploratory surgery is necessary. This can be negative, the organs all seem normal. In this case biopsies are performed because the lesions that cause the clinical signs may be microscopic. It may seem surprising not to find anything surgically curable, but it is better to explore than ignore a lethal problem without intervention. Fortunately, most abdominal explorations reveal an operable condition.

Signs of gastrointestinal illness

  • Vomiting is the first sign of a multitude of diseases affecting the digestive tract. If intestinal obstruction is present, there is usually no associated diarrhea, although this is possible. If the problem is acute (such as ingestion of a foreign body, acute vomiting is almost always present. Chronic signs such as intermittent vomiting or diarrhea, possibly associated with weight loss, may be due to inflammatory or tumour disease.
  • Age can give an indication of the type of problem. Foreign bodies are more common in young dogs and tumours in older dogs. The underlying problem of an animal may require abdominal exploration and sometimes biopsies of different organs.

Abdominal exploration and gastrointestinal surgery

  • The decision to have an exploratory laparotomy is often based on an X-ray or ultrasound examination. These tests are often suggestive of a specific problem affecting the stomach or intestines. The surgery is then performed to confirm the suspicion. Sometimes the abnormal gas filling found on X-ray is not due to an obstruction of the intestine and no major abnormalities are encountered. In this case, the animal may have some form of viral or tumour infiltration, or a bacterial infection. Biopsies are then performed to look for these pathologies.
  • Although it can be confusing to find nothing surgical, it is better to explore the abdomen than ignore a lethal problem without intervention. Fortunately, most abdominal explorations reveal a surgically curable condition.
  • If a foreign body is found in the stomach or intestines, the object is removed by making an incision at its level. If a portion of the intestine is in the process of necrosis due to the foreign body, it is then necessary to remove a portion of the digestive tract.
  • In the event of a gastric or intestinal tumour, its removal will be carried out if possible.
  • A feeding tube may be necessary, especially in undernourished animals with chronic disease. It is usually removed 10 days later if the animal is better.

Post-operative and convalescent care

  • After surgery, intensive care is needed to ensure a successful outcome. Infusions and antibiotics are administered for at least 24 hours.
  • Analgesics are administered for the comfort of your animal. Surveillance is maintained to ensure that the animal does not develop peritonitis (abdominal infection), especially if the digestive tract has had to be incised.
  • Re-feeding is started 24 hours after surgery depending on vomiting.
  • Most animals feel better in 2 to 4 days. Recovery is complete in 2 weeks, but tissue healing takes longer.
  • A restricted activity of 3 to 4 weeks must be set up. Walks are only hygienic and on a leash, jumping and running games are prohibited.
  • If your pet has cancer and chemotherapy is needed, it is usually started 2 weeks later, sometimes earlier. It is traditionally performed in 5 treatments spaced 2 to 3 weeks apart.

Possible Complications

- As with any surgery, complications can occur. Although rare, death during anesthesia may occur. The use of modern anaesthetic protocols and monitoring equipment (ECG, pulsed oximetry) minimises the risk.

- Infection is an infrequent complication since strict sterility techniques are used during the procedure and antibiotics are administered peritonitis is a serious but fortunately rare disorder. It is due to a release of the intestinal sutures at the incision and the presence of digestive contents in the abdomen.

- The risk period is between the second and fifth postoperative days. Emergency surgery is then necessary.

- Intussusception may follow abdominal surgery. The intestine then invaginates itself when the transit resumes. A re-intervention is then necessary.

- If a tumour portion of the intestine has been removed, recurrence is possible. Metastases may also occur.