Gastric dilation and volvulus (GDV) is an acute, life-threatening condition that primarily affects large and giant breed dogs. GDV is most often diagnosed by means of a right-lateral radiograph of the abdomen. Immediate goals in treatment of GDV include restoring circulating volume and gastric decompression with trocarization or oro-gastric tubing. Radiographic appearance and position of the stomach after oro-gastric tubing is poorly documented. The aim of this retrospective study is to evaluate the radiographic appearance of the stomach after GDV decompression by means of orogastric tubing and to understand if any radiographic pattern can predict persistent volvulus. Post oro-gastric tubing radiographic reports of 24 dogs with a diagnosis of gastric dilation and volvulus were collected; initial classification as "resolved" and "unresolved" volvulus was recorded, as well as time elapsed up to surgery. All radiographs were reevaluated to find and describe any common signs that can help in distinguish cases. Surgery reports, when available, were used to confirm the position of the stomach. 14 dogs had a "resolved" volvulus radiographic report and other 11 had a "unresolved" volvulus radiographic report. All the unresolved cases had the same radiographic pattern: the stomach showed a horseshoe shape with ventral concavity associated to variable amount of endoluminal gas. All of them underwent surgery; only four surgical reports described the gastric position and all of them confirmed the volvulus. The resolved cases were less homogeneous: 6 dogs showed a normal gastric axis, and in 8 cases we were not able to evaluate stomach position from radiography, due to a lack of endoluminal gas or to an "unusual" gastric appearance not belong to horseshoe shape or normal gastric axis. 11/14 dogs underwent surgery and 1/14 dog died before surgery. One dog with normal gastric axis had a clinical relapse after 9 hours and repeat a radiography showing an "unusual" gastric appearance; one case with lack of endoluminal gas was refilled with a mild amount of gas, showing a horseshoe shape. The "horseshoe shape" pattern indicates a partially decompressed stomach with persistent volvulus. A presumably normal gastric axis does not rule out persistent volvulus. In several cases the gastric position cannot be properly assessed radiographically due to a lack of endoluminal gas; in such cases no conclusion can be drawn about resolution of the volvulus.
RADIOGRAPHIC FINDINGS AFTER ORO-GASTRIC DECOMPRESSION IN 24 DOGS WITH GASTRIC DILATATION VOLVULUS
CITI, SIMONETTA;CARLUCCI, FABIO;MARCHETTI, VERONICA;
2015-01-01
Abstract
Gastric dilation and volvulus (GDV) is an acute, life-threatening condition that primarily affects large and giant breed dogs. GDV is most often diagnosed by means of a right-lateral radiograph of the abdomen. Immediate goals in treatment of GDV include restoring circulating volume and gastric decompression with trocarization or oro-gastric tubing. Radiographic appearance and position of the stomach after oro-gastric tubing is poorly documented. The aim of this retrospective study is to evaluate the radiographic appearance of the stomach after GDV decompression by means of orogastric tubing and to understand if any radiographic pattern can predict persistent volvulus. Post oro-gastric tubing radiographic reports of 24 dogs with a diagnosis of gastric dilation and volvulus were collected; initial classification as "resolved" and "unresolved" volvulus was recorded, as well as time elapsed up to surgery. All radiographs were reevaluated to find and describe any common signs that can help in distinguish cases. Surgery reports, when available, were used to confirm the position of the stomach. 14 dogs had a "resolved" volvulus radiographic report and other 11 had a "unresolved" volvulus radiographic report. All the unresolved cases had the same radiographic pattern: the stomach showed a horseshoe shape with ventral concavity associated to variable amount of endoluminal gas. All of them underwent surgery; only four surgical reports described the gastric position and all of them confirmed the volvulus. The resolved cases were less homogeneous: 6 dogs showed a normal gastric axis, and in 8 cases we were not able to evaluate stomach position from radiography, due to a lack of endoluminal gas or to an "unusual" gastric appearance not belong to horseshoe shape or normal gastric axis. 11/14 dogs underwent surgery and 1/14 dog died before surgery. One dog with normal gastric axis had a clinical relapse after 9 hours and repeat a radiography showing an "unusual" gastric appearance; one case with lack of endoluminal gas was refilled with a mild amount of gas, showing a horseshoe shape. The "horseshoe shape" pattern indicates a partially decompressed stomach with persistent volvulus. A presumably normal gastric axis does not rule out persistent volvulus. In several cases the gastric position cannot be properly assessed radiographically due to a lack of endoluminal gas; in such cases no conclusion can be drawn about resolution of the volvulus.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
