Wednesday, May 26, 2010

Blue hand towel

The puppy in front of me was flat-out. Shoulders hunched, eyes squinting, tongue hanging out. You could tell instantly that she felt terrible. The question was why? As I looked at her triage sheet, my eyes came to the line: "reason for your visit today." The owners had written: vomiting, won't eat, dumpy, vomited up bits of a towel today.


I did my exam on the dog, stepped out of exam room 3, and merrily told my technicians (who were hopping due to the busy-ness of the day) - "foreign body on aisle 3."

When I gently palpated the dog's abdomen, she cried out in pain. She was very dehydrated, and she was very, very depressed. Xrays showed something plastic in the abdomen, although I was not convinced that the plastic was the problem. I recommended an exploratory surgery.

Three hours later, I got my answer as I slid the intestines out of the abdomen and onto my lap sponges. The intestines were bright pink, angry, and attempting to peristalse (squeeze) frantically. They were unable to do much because they had become kinked up completely on a linear foreign body - likely the blue towel. Luckily, we did not delay on surgery, so the intesitines were still healthy and pink. There were no areas where necrosis had started and no areas of intestinal perforation yet.

I had to make 2 intestinal incisions, as well as a gastrotomy (incision into the stomach) to remove all of the hand towel, but it all came out.

Three days later, my patient is eating, drinking, bouncing around, and acting like a Jack Russell puppy should. In another 24 hours, I'll add this to my win column. It helps me feel better about this - even though I know that wasn't my fault. It still bothers me.

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