Enterotomy / enterectomy in Reptiles | Vetlexicon
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Enterotomy / enterectomy

ISSN 2398-2985


Introduction

  • Relatively uncommon procedure performed for access to the intestinal tract.
  • The intestinal tract of certain species is very fragile and enterectomy is not always possible, eg small lizards. Enterotomy is commonly performed for foreign body removal in snakes and lizards after ingestion of inappropriate objects.
  • Due to the shape of snake bodies and anatomical positioning of the gastrointestinal tract, enterectomies are contraindicated in most cases.

Uses

  • Foreign body removal.
  • Intussusception.
  • Neoplasia.
  • Intestinal biopsy Biopsy overview.
  • Iatrogenic trauma.
  • Resection due to perforation by foreign bodies, eg substrate ingestion in bearded dragons Bearded dragons.

Advantages

  • The surgery allows for direct visualization and assessment of the gastrointestinal tract.
  • Biopsies and foreign body removals can be performed during the same surgery.

Disadvantages

  • Invasive procedure requiring celiotomy Celiotomy.
  • Risk of anesthesia Anesthesia overview.
  • High risk of post-operative complications.
  • Intensive post-operative care often required.

Technical problems

  • Intestinal content leakage into the abdomen.
  • Need for specialized equipment.
  • Requires experienced staff.

Alternative techniques

Alternative techniques to enterotomy

  • Medical treatment of foreign body ingestion possible in some cases, eg substrate ingestion in bearded dragons Bearded dragons. This is achieved through adequate analgesia Analgesia, prokinetic medication and hydration.

Time required

Preparation

  • Dependent on species, longer in chelonians due to shell preparation, which requires a longer scrubbing time.
  • 5-10 min for small patients.
  • 10-15 min for chelonians and big snakes.
  • For snakes, prepare as large of an area as possible. Incisions must often be extended and enterotomy sometimes require multiple ones.

Procedure

  • 30-60 min for core procedure, but dependent on difficulty of procedure and the species operated on, eg large snakes requiring enterotomy for foreign body removal will require a larger incision for access to the intestinal tract.

Decision taking

Criteria for choosing test

  • Diagnostic imaging indicative of a foreign body causing partial or complete obstruction - either radiography or ultrasonography.
  • Suspected neoplasia of the intestinal lining.
  • Need for biopsy where endoscopy unavailable or species restricted. Endoscopy is often prohibited by the size of the patient, eg small tortoises.
  • Patients unresponsive to medical management for conditions such as foreign bodies in reptiles, eg substrate ingestion in lizards Gastrointestinal obstruction.

Risk assessment

  • Patients are often critical and at a high risk of general anesthesia due to negative energy balance because of dehydration, nutritional deficits and secondary conditions such as hepatic lipidosis.
  • Chronicity of the presenting problem needs to be considered as adhesions often develop quickly. These may not be correctable through surgery and can lead to euthanasia of the patient. Secondary hepatic lipidosis often present in reptiles.

Requirements

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Preparation

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Technique

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Aftercare

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