Laparoscopic repositioning of chronic gastric volvulus in a dog

Frans G Van Heerden,Robert M Kirberger,Marthinus J Hartman,Vanessa Mcclure

doi:10.4102/jsava.v89i0.1713

Abstract

A 12-year-old spayed Newfoundland bitch was presented with chronic non-productive vomiting, regurgitation and coughing of six weeks’ duration. On clinical examination, the dog was depressed with no other significant findings. Haematology and biochemistry investigations detected no abnormalities. Thoracic and abdominal radiographs revealed a megaoesophagus and an abnormally positioned pylorus. A thoracic and abdominal computed tomography scan confirmed the abnormal position of the stomach, together with moderate aspiration pneumonia. Laparoscopic examination of the peritoneal cavity revealed the greater omentum wrapped over the stomach, with a fold visualised between the abnormally positioned pyloric antrum and the gastric corpus. A 180-degree clockwise gastric rotation was laparoscopically diagnosed and corrected. The normal position of the stomach was confirmed before a laparoscopic-assisted incisional gastropexy was performed. Post-operatively the vomiting and regurgitation resolved and the patient was discharged. Twenty-four hours after discharge, the dog was presented with deteriorating clinical signs of aspiration pneumonia. The owner declined treatment, additional diagnostics as well as a necropsy and requested euthanasia. Chronic gastric volvulus should be considered as a rare differential diagnosis in dogs with non-specific, chronic gastrointestinal signs. Radiography, computed tomography and laparoscopy are valuable diagnostic aids in making this diagnosis. Chronic gastric volvulus can be successfully reduced laparoscopically as reported here for the first time.

Highlights

Gastric dilatation and volvulus (GDV) occurs commonly in large, deep-chested adult dogs (Brockman, Washabau & Drobatz 1995; Green, Brown & Agnello 2012)
Gastric dilatation and volvulus is defined as pyloric rotation of 90–360 degrees along the mesenteric axis of the stomach, leading to outflow obstruction and gastric dilatation
Chronic gastric volvulus has been reported as a 45–180 degree clockwise or uncommonly anticlockwise rotation of the pylorus, without causing complete outflow obstruction and acute dilatation (Paris et al 2011)

Summary

Introduction

Gastric dilatation and volvulus (GDV) occurs commonly in large, deep-chested adult dogs (Brockman, Washabau & Drobatz 1995; Green, Brown & Agnello 2012). Unlike GDV, chronic gastric volvulus is uncommon in dogs (Boothe & Ackerman 1976; Frendin, Funkquist & Stavenborn 1988; Leib, Monroe & Martin 1987; Oakes & Pechman 1992; Paris et al 2011) Dogs affected by this condition present with chronic, intermittent, non-specific clinical signs that include vomiting, anorexia and/or weight loss (Paris et al 2011; Radlinsky 2013). Chronic gastric volvulus has been reported as a 45–180 degree clockwise or uncommonly anticlockwise rotation of the pylorus, without causing complete outflow obstruction and acute dilatation (Paris et al 2011). Even though the first successful laparoscopic correction of acute GDV in two clinically affected dogs was reported by Rawlings et al (2002), the case presented here is to the best of the authors’ knowledge the first report of laparoscopic confirmation, repositioning and gastropexy of chronic gastric volvulus

Ethical consideration

Discussion

Conclusion