Canis ISSN: 2398-2942

Intestine: linear foreign bodies

Contributor(s): Ken Harkin, James Simpson

Introduction

  • Cause: string, fishing line, tinsel, needle and thread, recording tape are common.
  • Usually start as partial obstruction.
  • Continued presence can lead to large sections of bowel becoming non-functional and essentially completely obstructed.
  • Signs: vomiting, melena.
  • Diagnosis: history, clinical examination and radiography.
  • Treatment: surgery in most cases.
  • Prognosis: guarded, particularly if chronic.

Pathogenesis

Etiology

  • Ingestion of linear foreign body, eg audio cassette tape, needle and thread, string.
  • Proximal end frequently anchored - look under tongue, in pharynx/esophagus and at pylorus.

Pathophysiology

  • Usually starts as a partial obstruction → presence in the bowel can cause large sections of the bowel to become non-functional → stasis → bacterial overgrowth → endotoxemia.
  • Typically the object is either looped around the base of the tongue or trapped at the pylorus → normal smooth muscle contraction of the small intestine propels the object aborally → damage to the mesenteric border of the bowel through which the foreign body passes.
  • Continuation of peristalsis against the pressure of the fixed linear object will eventually result in plication of intestine and multiple perforation of the gut → leakage and peritonitis Peritonitis.
  • When lacerations occur, mortality increases dramatically.
  • Fluids lost by emesis and sequestration into lumen → metabolic acidosis Acid base imbalance with hypokalemia Hypokalemia , hyponatremia, and hypochloremia.

Timecourse

  • Days.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Shaiken L (1997) Determining the type of intestinal obstruction. Vet Med 92 (11), 950-951 VetMedResource.
  • Evans K L, Smeak D D & Biller D S (1994) Gastrointestinal linear foreign bodies in 32 dogs - a retrospective evaluation and feline comparison. JAAHA 30 (5), 445-450 VetMedResource.
  • Lamb C (1994) Radiological identification of non-opaque intestinal foreign bodies. Vet Rad 35 (2), 87-88 Wiley Online Library.
  • Anderson S, Lippincott C L & Gill P J (1992) Single enterotomy removal of gastrointestinal linear foreign bodies. JAAHA 28 (6), 487-490 VetMedResource.


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