A 6-year-old, spayed female Labrador retriever was presented 48 hours after an intestinal resection and anastomosis for management of a small intestinal foreign body. Abdominal ultrasound confirmed the presence of peritoneal effusion. Cytology of fluid collected by abdominocentesis revealed a large number of degenerate neutrophils with intracellular cocci. A diagnosis of septic peritonitis was made, presumably because of dehiscence of the anastomosis. Upon repeat exploratory celiotomy, the intestinal anastomosis (located 4 cm orad to the cecum) was found to be leaking intestinal contents into the abdomen. The distal ileum, cecum, and proximal colon were resected. An end-to-end, ileocolic anastomosis was performed and subsequently exteriorized into the subcutaneous space via a paramedian incision through the abdominal wall. The anastomosis was inspected daily for 4 days before it was returned to the abdomen and the subcutaneous defect was closed. Serial cytology of the peritoneal fluid, which was performed during this 4-day postoperative period, confirmed progressive resolution of peritonitis. The dog was discharged from the hospital 2 days following return of the anastomosis into the abdomen. Externalized intestinal anastomosis is used with good success in human medicine for repair of colonic injuries. In this case, externalization of the anastomosis permitted healing of the intestinal anastomosis in an environment isolated from the detrimental effects created by septic peritonitis. In addition, direct visualization of the anastomosis allowed assessment of healing. To our knowledge, this procedure has not been previously reported in companion animals.
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July/August 2010
Case Reports|
July 01 2010
Externalized Ileocolic Anastomosis: Case Report
James Simcock, BVSc;
James Simcock, BVSc
Southpaws Specialty Surgery for Animals (Simcock), 3 Roper Street, Moorabbin, Victoria, 3189 Australia
Southern Animal Emergency Centre (Kuntz, Newman), 248 Wickham Road, Highett, Victoria, 3190 Australia
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Charles A. Kuntz, DVM, MS, Diplomate ACVS, Member ACVSc;
Charles A. Kuntz, DVM, MS, Diplomate ACVS, Member ACVSc
Southpaws Specialty Surgery for Animals (Simcock), 3 Roper Street, Moorabbin, Victoria, 3189 Australia
Southern Animal Emergency Centre (Kuntz, Newman), 248 Wickham Road, Highett, Victoria, 3190 Australia
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Raquel Newman, BVSc, Member ACVS (EMCC)
Raquel Newman, BVSc, Member ACVS (EMCC)
Southpaws Specialty Surgery for Animals (Simcock), 3 Roper Street, Moorabbin, Victoria, 3189 Australia
Southern Animal Emergency Centre (Kuntz, Newman), 248 Wickham Road, Highett, Victoria, 3190 Australia
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J Am Anim Hosp Assoc (2010) 46 (4): 274–280.
Citation
James Simcock, Charles A. Kuntz, Raquel Newman; Externalized Ileocolic Anastomosis: Case Report. J Am Anim Hosp Assoc 1 July 2010; 46 (4): 274–280. doi: https://doi.org/10.5326/0460274
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