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Gastric Foreign Body: Finding a Needle in a Haystack

January 06, 2010 By: Dr. K Category: Case Review

[singlepic=109,200,,,left]I was recently awarded the opportunity to diagnose and correct a gastric foreign body. I had a phone call from a concerned owner who reported her young Samoyed, who I’ll call Hoover, was caught with a spool of thread in her mouth. According to the owner, Hoover had a propensity to consume anything and everything in sight. The owner was concerned with a threaded needle that was missing. I recommended monitoring Hoover’s feces in the coming days for any evidence of a needle and thread. Five days later, no needle. The dog remained asymptomatic.

[singlepic=111,150,,,right]The dog was admitted for radiographs which revealed a needle in the cranial midline abdomen. Discussion with the owner touched on the risk of needle migration within the abdomen or even though the diaphragm and into the chest. We also agreed about the unlikelihood the needle would pass through the GI tract given how much time had passed. We decided to take Hoover to surgery for an abdominal exploratory. We were prepared to find the needle in the stomach, intestines, liver, or free floating in the abdomen.

The abdominal explore began by observing the liver and abdominal cavity for evidence of a threaded needle. Then the stomach was exteriorized and I palpated significant amounts of firm material and digesta. The length of intestines were examined. Once I determined no foreign material was present elsewhere in the GI tract, a gastrotomy was performed. Two stay sutures were placed in the oral and aboral portions of the fundus. An incision was made near the greater curvature of the stomach. [singlepic=110,200,,,left]Initial digital exam revealed large amounts of foreign material in both the pyloric and esophageal regions. Two large pieces of soft plastic material, resembling snack cake wrappers, were removed from the fundic and esophageal regions. A large firm glom of material was palpable in the pyloric region. Steady traction yielded a large baseball-sized orb of chewed pieces of white plastic, undiscernible foreign material, and, in the dead center, a needle with dark thread wrapped around the entire mass.

The prognoses for the dog’s recovery and future repeat offenses are both excellent. Hoover will most likely return to my care for a foreign body in years to come.

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