Small Animal Surgical Emergencies. Группа авторовЧитать онлайн книгу.
A culture swab should be obtained and submitted for aerobic/anaerobic culture and sensitivity to help guide antimicrobial therapy. Placement of a closed‐suction abdominal drain should also be considered.
Colopexy is recommended to minimize the risk of disease recurrence. For this procedure, the serosal surface of the mid‐descending colon is gently scarified with a #11 or #15 blade. The scarified colon is then sutured to an incision in the left abdominal wall with two layers of absorbable monofilament suture material (typically polydiaxonone). Alternatively, colopexy can be performed with a single continuous suture line without scarification of the colon [9].
Postoperative Care and Prognosis
Patients recovering from colonic torsion are at risk of severe shock, reperfusion injury, and sepsis. Judicious postoperative monitoring and supportive therapies should be instituted. This includes frequent assessment of patient temperature, heart rate, pulse quality, and respirations. Additionally, non‐invasive blood pressure monitoring and continuous electrocardiography are recommended for the first 24–48 hours postoperatively. IV fluid therapy, analgesics, gastrointestinal protectants, and anti‐emetics are indicated in all patients. In those suffering from coagulopathy, plasma transfusion may be necessary. Similarly, albumin transfusion may be warranted in severely hypoalbuminemic patients. Slow reintroduction of enteral nutrition is recommended, starting six to eight hours after surgery.
Prognosis for colonic torsion is dependent on the duration and degree of torsion but appears to be better than its small intestinal counterpart (mesenteric torsion) [1, 6]. In the largest case series to date, of 13 dogs diagnosed with the disease [1], three dogs were euthanized intraoperatively. Ten dogs survived surgery and were discharged from the hospital. Of these, nine were alive at follow‐up a median of 24 months postoperatively.
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