AI Article Synopsis
- The study assessed the effectiveness of early ultrasound in diagnosing postoperative bowel dehiscence in cats and dogs after intestinal surgery, focusing on key ultrasound indicators for identifying dehiscence.
- Out of 114 animals, only 7 dogs showed ultrasound-suspected dehiscence, with all but one confirmed during subsequent surgeries, highlighting specific ultrasound features like wall discontinuity and gas bubbles as reliable signs.
- The findings indicate that ultrasound can significantly improve early detection of dehiscence, leading to a high survival rate of 83% after revision surgery and a short median hospitalization duration of 2 days.
Article Abstract
Objective: To evaluate the feasibility and reliability of early ultrasound diagnosis for postsurgical bowel dehiscence and find the most reliable ultrasound criteria for dehiscence identification. Additionally, to determine the impact of early ultrasound detection of leakage in terms of survival and duration of hospitalization. Finally, to assess the need for systematized screening or checkup of the population at risk of dehiscence only.
Animals: 31 cats and 83 dogs.
Methods: A retrospective, records-based study was performed on 83 dogs and 31 cats (114 total) undergoing small intestinal surgery. Epidemiologic data, clinical signs, surgical procedures, pre- and postoperative ultrasound findings at 48 to 96 hours, hospitalization duration, complications, and general outcomes were recorded. Univariate and multivariate analyses were used to identify ultrasound findings associated with dehiscence.
Results: Dehiscence was suspected by ultrasound for 0 of 31 cats and 7 of 83 dogs (2 of 49 for enterotomy and 5 of 34 for enterectomy). Every suspected dehiscence was confirmed during revision surgery except one enterectomy revision, which was declined by the owner. Neither this case nor those without ultrasound evidence of dehiscence developed clinical signs of intestinal leakage. Direct visibility of wall discontinuity, presence of gas bubbles, and liquid in vicinity of the intestinal surgical site were statistically associated with early dehiscence. Survival rate after the second surgery was 83%. Median hospitalization time after the second surgery for dehiscence was 2 days (minimum, 2 days; maximum, 4 days).
Clinical Relevance: Postoperative ultrasound examination between 48 and 96 hours after intestinal surgery allows early and sensitive detection of intestinal dehiscence. Survival rate after revision surgery was significantly higher than that associated with septic peritonitis.
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| http://dx.doi.org/10.2460/javma.23.10.0599 | DOI Listing |
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