Gastrointestinal (GI) surgery may be performed for a variety of reasons, including foreign body removal, cancer, ulcers, intussusception, trauma, or for biopsies to diagnose certain diseases.  Often GI surgery begins as an “abdominal exploratory surgery” because the surgeon is looking for a problem that is suspected based on an ultrasound, radiograph or endoscopy.  GI surgeries involve making an incision into the stomach, intestine, colon and/or esophagus, and then suturing the incision closed.  Healthy GI tissues generally heal well with the exception of the esophagus.  Tissues that are unhealthy, or in animals that are debilitated by whatever problem they may have, heal less consistently and have a higher risk of complications with surgery.

FOREIGN BODIES

Dogs and cats may ingest a wide array of foreign materials.  These can lodge in the esophagus, stomach or small intestine.  Sometimes, upper GI endoscopy can allow removal of these foreign objects.  If this is not possible, then surgery is needed. 

Foreign bodies can be solitary or linear.  An example of a solitary foreign body is a ball that lodges somewhere in the GI tract.  Linear foreign bodies lodge at a certain place, like under the tongue or in the stomach, and then the remainder of the foreign material tries to snake through the intestine, like a drawstring through a waistband.  Both of these types of foreign bodies may be relatively easy to deal with surgically, by making one or more incisions into healthy GI tissues to remove them.  On the other hand, either can cause very serious problems, including bowel perforation and /or death of the bowel.  These foreign bodies may need to be treated by removing a block of abnormal intestine and suturing the ends back together, called a resection and anastamosis procedure.  The prognosis for easily removed foreign bodies with healthy GI tissues in the stomach or the intestine is generally good.  Linear foreign bodies, unhealthy GI tissues and esophageal foreign bodies generally carry a more guarded prognosis.

CANCER

A number of types of cancer may be found in the GI tract.  If cancer is spread diffusely throughout the GI tract, then intestinal biopsies may be taken.  If cancer is in one particular section of bowel or the stomach, then this may be removed.  Cancers that occur in the GI tract may be malignant or benign.  The diagnosis of what type of cancer is present has to be done by a pathologist, so all GI biopsies are submitted for microscopic review.  We cannot tell what type of cancer is present until these results are available.  Further treatment and monitoring can be recommended based on biopsy results. 

ULCERS

Ulcers may form in the GI tract secondary to trauma, shock, ingested toxins, cancer, diseases that produce extra acid or histamine, diseases of the kidney or liver, and side effects of certain medications.  Ulcers are often suspected if blood is found in vomit, or if the stool has a black tarry appearance.  They may be diagnosed with upper GI endoscopy.  Ulcers that rupture cause severe signs of pain, shock and infection, and may be diagnosed with radiographs or ultrasound.  Ulcers that have not ruptured are first treated with medications to coat the stomach and allow it to heal and to decrease histamine or stomach acid.  Treatment is also begun for any other diseases that may be playing a part in generating ulcers.  Ulcers that perforate, or chronic ulcers that do not respond to medical treatment, are addressed surgically by removing the ulcer.  If the ulcer perforated the GI tract, and GI contents have spilled into the belly, then the belly may need to be cleaned out multiple times to control infection.  This is a severe situation because these animals may become overwhelmed by infection, or their organs may shut down.  They need aggressive medical treatment in addition to surgery, and are often in the hospital for multiple days.

INTUSSUSCEPTION

Intussusception occurs in young dogs secondary to viruses, parasites, foreign bodies, or inflammation, and in older dogs secondary to cancer.  A segment of bowel invaginates into an adjacent segment of bowel.  Think of a tube sock stuck within another tube sock.  The bowel can become trapped, or it can slide in and out.  An intussusception can sometimes be felt on a physical examination.  An ultrasound of the belly is usually most helpful for diagnosing this problem, where we see a “target” of rings that represents bowel-on-bowel. 

Surgery is recommended.  The bowel is stretched out to straighten it.  Sometimes it needs to be removed if it is unhealthy or if it cannot be straightened out by a resection and anastamosis.  The bowel is then tacked into place to hopefully prevent it from happening again.

TRAUMA

Trauma to the GI tract can occur because of wounds that penetrate through the abdominal wall and penetrate into the GI tract.  Bites, gunshot wounds, stab wounds, and blunt trauma are examples.  Any wound that enters the abdomen should ideally be explored to inspect all of the organs for damage and to help clear infection. 

 BIOPSIES

Biopsies are taken of the GI tract whenever a disease that affects large amount of it is suspected, or when an abdominal exploratory surgery does not show a direct cause of vomiting and/or diarrhea.  Surgical biopsies are used with there is a concern that an endoscope will not reach a diseased area or if all of the stomach or intestine layers are needed for a diagnosis.  These biopsies are read by a pathologist to determine what medical treatment is needed.  These surgeries do not usually “fix” the problem, but they are used to help determine the diagnosis.