Felis ISSN 2398-2950

Stomach: gastric foreign body

Contributor(s): Ed Hall, Cheryl Hedlund, Philip K Nicholls

Introduction

  • Surgical recovery of gastric foreign bodies should only be considered where conservative management is inappropriate or endoscopic retrieval has failed.
  • Signs: vomiting (acute/chronic). May be incidental finding during investigation for other diseases. Some gastric foreign bodies may cause only intermittent pyloric obstruction and can persist for months or even years without diagnosis. Weight loss is normally quite pronounced in such chronic cases.
  • Diagnosis: history and behavior of the animal is often suggestive.
  • Treatment: not all gastric foreign bodies require removal. Most sharp foreign bodies, eg needles, will pass safely out of the stomach without incident. Bones are usually digested.

Pathogenesis

Etiology

  • Sharp or potentially penetrating objects, eg sewing needles, fishhooks.
  • Linear materials Intestine: linear foreign body removal, eg string.
  • Obstructive materials, eg rubber/plastic toys, organic material.

Pathophysiology

  • Large or impacted material   →   pyloric obstruction   →   vomiting   →   electrolyte loss   →   hypokalemia and metabolic alkalosis.
    Hypoperfusion may   →   metabolic acidosis.
  • Intermittent pyloric obstruction   →   intermittent chronic vomiting   →   weight loss.
  • Sharp foreign bodies   →   mucosal injury   →   vomiting and/or perforation of stomach   →   tracking through abdomen   →   localized adhesions   →   rarely generalized peritonitis. (Unless foreign body attached to thread which provides a tract for persistent contamination from the gastric lumen.)

Timecourse

  • Hours   →   weeks (depends on type/position of foreign body).

Diagnosis

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Treatment

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Prevention

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Bebchuk T N (2002) Feline gastrointestinal foreign bodies. Vet Clin North Am Small Anim Pract 32 (4), 861-880 PubMed.


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