canis - Articles
Stomach: foreign body
Synonym(s): Gastric FB
Introduction
- Recovery of gastric foreign bodies is the most common indication for gastrotomy. Surgical recovery should only be considered where conservative management is inappropriate or endoscopic retrieval has failed.
- Signs:
- Asymptomatic.
- Vomiting (acute/chronic).
- May be incidental finding during investigation for other diseases.
- Weight loss may occur in chronic cases.
- Diagnosis: history, signs, radiography or gastroscopy.
- Treatment: not all gastric foreign bodies require removal.
- Prognosis: generally very good.
Presenting signs
- Vomiting - may be intermittent or persistent.
Clinical signs depend on whether foreign body is obstructing the pylorus or lying in the fundus.
- Weight loss (chronic intermittent pyloric obstruction).
- Generalized peritonitis (some penetrating foreign bodies).
- Dyspnea (due to diaphragmatic perforation).
- Jaundice and anemia - zinc foreign bodies.
- Neurological signs, anemia and GI symptoms, lead toxicity.
Acute presentation
- Persistent vomiting.
- Shock Shock (acute intestinal perforation).
Age predisposition
- Young animals more likely to ingest FB.
Special risks
- Anesthesia: fluid, electrolyte and acid-base imbalances require correction before surgery.
Pathogenesis
Predisposing factors
General
- Some dogs are 'stone chewers' or ball chasers and may repeatedly swallow these objects.
- Greedy dogs with scavenging habits may repeatedly get bone foreign bodies.
Pathophysiology
- Asymptomatic:
- Non-irritant foreign body lying in fundus.
- May exhibit pica, salivation, polydipsia, polyuria.
- May lead to hypertrophic gastritis long-term Stomach: chronic hypertrophic gastritis.
- Acute vomiting:
- Associated with pyloric obstruction.
- Dehydration, metabolic alkalosis Acid base imbalance.
- Chronic vomiting:
- Associated with chronic irritation.
- Secondary hypertrophic gastritis Stomach: chronic hypertrophic gastritis.
- Intermittent vomiting:
- Movement of foreign body in and out of pylorus.
- Signs of zinc or lead toxicity if these FBs are ingested.
Timecourse
- Hours - weeks (depends on type/position FB).
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Evans K L, Smeak D D & Biller D S (1994) Gastrointestinal linear foreign bodies in 32 days - a retrospective evaluation and feline comparison. JAAHA 30 (5), 445-450 AGRIS FAO.
Other sources of information
- Twedt D C (1992) Vomiting. In: Veterinary Gastroenterology. N V Anderson (ed), Lea & Febiger, Philadelphia. p 336.