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Exploratory Laparotomy (exploratory + laparotomy)

Distribution by Scientific Domains

Medical Sciences	100%

Distribution within Medical Sciences

General & Introductory Veterinary Medicine	27%
Transplantation	11%

Selected Abstracts

Pseudomonas aeruginosa sepsis in an adult horse with enteric Salmonellosis

JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 3 2006
DACVIM, Imogen C. Johns BVSc
Abstract Objective: To report a case of enteric Salmonellosis and Pseudomonas aeruginosa bacteremia in an adult horse. Case summary: A 7-year-old mare presented for signs of acute abdominal pain. Exploratory laparotomy allowed surgical correction of right dorsal displacement of the large colon with a 180° volvulus at the cecocolic ligament. Postoperatively, the mare developed fevers, leukopenia, and diarrhea. Salmonella newport was cultured from the feces and P. aeruginosa from 2 consecutive blood cultures. The mare responded well to intensive medical therapy. New or unique information provided: Bacteremia associated with colitis is unusual in an adult horse, although the percentage of animals that may be bacteremic is unknown. The bacteria isolated, P. aeruginosa, a common pathogen of other sites in the horse, has not, to our knowledge, been previously reported as a cause of bacteremia and septicemia in an adult horse. [source]

Ligation of the caudal mesenteric artery during resection and anastomosis of the colorectal junction for annular adenocarcinoma in two dogs

AUSTRALIAN VETERINARY JOURNAL, Issue 9 2009
SK Sarathchandra
An 8-year-old terrier cross and a 10-year-old German Shorthaired Pointer presented to the University Veterinary Centre, Sydney, for investigation of long-standing tenesmus and dyschezia. Both patients had an annular adenocarcinoma at the colorectal junction. Exploratory laparotomy was performed and the affected large intestinal segment was removed by resection and anastomosis. In both dogs, the caudal mesenteric artery was intimately associated with the mass, necessitating its ligation and transection. Postoperatively, there was no evidence of anastomosis breakdown in either case and both animals recovered well from surgery. The dogs were euthanased 8 and 10 months, respectively, after surgery because of clinical signs relating to metastatic disease. [source]

Influence of laparoscopy on postoperative recurrence and survival in patients with ruptured hepatocellular carcinoma undergoing hepatic resection

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2004
B. H. H. Lang
Background: Use of laparoscopy in patients with gastrointestinal cancer has been associated with port-site and peritoneal tumour metastases. The effect of laparoscopy on tumour recurrence and long-term survival in patients undergoing resection of ruptured hepatocellular carcinoma (HCC) remains unknown. Methods: Between June 1994 and December 2001, 59 patients with ruptured HCC underwent surgical exploration with a view to hepatic resection. Laparoscopy with laparoscopic ultrasonography was performed in 33 patients; the other 26 patients underwent exploratory laparotomy without laparoscopy. Perioperative and long-term outcomes were compared between the two groups. Results: Exploratory laparotomy was avoided in 12 of 13 patients with irresectable HCC who had a laparoscopy. The hospital stay of these 12 patients was significantly shorter than that of eight patients found to have irresectable HCC at exploratory laparotomy (median 11 versus 15 days; P = 0·043). Twenty patients had a laparoscopy followed by open resection of HCC, whereas 18 patients underwent laparotomy and resection without laparoscopy. There were no significant differences in disease-free (16 versus 19 per cent; P = 0·525) and overall (32 versus 48 per cent; P = 0·176) survival at 3 years between the two groups. The tumour recurrence pattern was similar between the two groups, and there were no port-site or wound metastases. Conclusion: Use of diagnostic laparoscopy in patients with ruptured HCC helps avoid unnecessary exploratory laparotomy. The present data suggest that laparoscopy does not have an adverse effect on tumour recurrence or survival in patients who undergo resection. Copyright © 2004 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Recurrent colics in a 9-year-old Arabian stallion due to several congenital anomalies

EQUINE VETERINARY EDUCATION, Issue 11 2008
M. P. Robert
Summary A 9-year-old Arabian stallion was presented for evaluation of recurrent colic problems of 2 years' duration. These colic episodes were associated with a right sided abdominal distension. An exploratory laparotomy revealed a colonic diverticulum that was resected en bloc. Two days later, following signs of acute colic, a second laparotomy showed incarceration of the distal jejunum into a mesodiverticular band combined with haemorrhage of a mesenteric arterial branch. In addition, an abnormally short jejunum (10 m) was also observed. An end-to-end jejunojejunostomy was performed. Following surgery the horse developed septic peritonitis, ptyalism and became dysphagic. Ten days after the second surgery, an infected oesophageal diverticulum causing regional inflammation was diagnosed endoscopically and euthanasia was performed. Post mortem examination showed a 40 cm long diverticulum lateral to the oesophagus. Histology suggested a congenital nature of the colonic and oesophageal diverticuli. [source]

Case Report of Cardiac Arrest, Abdominal Compartment Syndrome, and Thoracic Aortic Injury with Endovascular Repair of Thoracic Aortic Tear

JOURNAL OF CARDIAC SURGERY, Issue 4 2007
Randy M. Stevens M.D.
Currently, endografts are not FDA-approved for treating thoracic aortic injury (TAI). We report a case of TAI who presented in hemorrhagic shock and preoperative cardiac arrest who was successfully treated with large volume resuscitation, closed chest cardiac massage, exploratory laparotomy, and thoracic endografting. [source]

Kikuchi-Fujimoto's Disease with Skin Manifestations

JOURNAL OF CUTANEOUS PATHOLOGY, Issue 1 2005
I.T. Yu
A fourteen-year-old female presented with persistent fever, abdominal pain, splenomegaly and multiple intra-abdominal lymphadenopathies. She underwent an exploratory laparotomy. Biopsies of the mesenteric lymph nodes revealed necrotizing histiocytic lymphadenitis, characterized by para-cortical fibrinous necrosis with karyorrhectic debris and histiocytic palisading, and paucity of the polymorphic neutrophils. She also developed concurrent skin lesions with scattered small non-itching vesicles and blisters over her back and lower legs. A punch biopsy revealed vacuolar interface changes, sub-epidermal blister formation, mild superficial perivascular infiltration, and follicle necrosis. Karyorrhectic debris and CD68-positive cells are noted around the follicle. A direct immunofluorescent study was negative for complement or immunoglobulin depositions. The patient was diagnosed as Kikuchi-Fujimoto's disease, or necrotizing histiocytic lymphadenitis, a benign self-limited lymph node disorder most commonly occurred in young females. Patients with Kikuchi's disease are typically presented with isolated cervical lymphadenopathy with or without accompanying fever. Multiple lymph node involvement, splenomegaly and/or cutaneous lesions are rare occurrences. The present patient experienced a severe inflammatory response syndrome manifested by respiratory failure, pancytopenia, and disseminated intravascular coagulopathy. She recovered completely after two weeks of intensive medical treatment. She has had no respiratory symptoms, residual lymphadenopathies or documented skin lesions in her follow-up three months after discharge. [source]

Uterine preservation in a woman with spontaneous uterine rupture secondary to placenta percreta on the posterior wall: A case report

JOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2009
Le-Ming Wang
Abstract Several cases in which uteruses have been preserved in women with placenta percreta have been reported. We herein report a 38-year-old woman with a history of previous cesarean section who was admitted with lower abdominal pain and vaginal bleeding at 31 weeks of gestation. An urgent exploratory laparotomy revealed active bleeding from the uterine rupture on the posterior uterine wall. A female infant weighing 1560 g, with Apgar scores of 1, 1, and 3 at 1, 5, and 10 min, respectively, was delivered, and the placenta was removed. We performed bilateral uterine vessel occlusion, followed by wedge resection of the ruptured uterine wall with the aid of an intrauterine muscle injection of 20 IU oxytocin, a local injection of diluted vasopressin (1:60) into the myometrium around and into the rupture site, and an intramuscular injection of 0.2 mg methylergonovine, primary repair of the defect, and an additional 24-h postoperative oxytocin infusion (30 IU in 5% dextrose 500 mL) to preserve the uterus successfully. Although the overall blood loss was 3700 mL, no disseminated intravascular coagulopathy occurred after the patient had received adequate blood transfusion. The postoperative pathological diagnosis was placenta percreta with uterine rupture. The patient and her baby were discharged uneventfully. In some cases of spontaneous uterine rupture secondary to placenta percreta, we can preserve the uterus by performing bilateral uterine vessel occlusion and wedge resection of the ruptured uterine wall. [source]

Rectovaginal fistula following colectomy with an end-to-end anastomosis stapler for a colorectal adenocarcinoma

JOURNAL OF SMALL ANIMAL PRACTICE, Issue 12 2006
A. Klein
An 11-year-old, female neutered Labrador retriever was presented with a micro-invasive differentiated papillar adenocarcinoma at the colorectal junction. A colorectal end-to-end anastomosis stapler device was used to perform resection and anastomosis using a transanal technique. A rectovaginal fistula was diagnosed two days later. An exploratory laparotomy was conducted and the fistula was identified and closed. Early dehiscence of the colon was also suspected and another colorectal anastomosis was performed using a manual technique. Comparison to a conventional manual technique of intestinal surgery showed that the use of an automatic staple device was quicker and easier. To the authors' knowledge, this is the first report of a rectovaginal fistula occurring after end-to-end anastomosis stapler colorectal resection-anastomosis in the dog. To minimise the risk of this potential complication associated with the limited surgical visibility, adequate tissue retraction and inspection of the anastomosis site are essential. [source]

Pathogenesis and outcome of extrahepatic biliary obstruction in cats

JOURNAL OF SMALL ANIMAL PRACTICE, Issue 6 2002
P. D. Mayhew
Extrahepatic biliary obstruction (EHBO) was confirmed at surgery or necropsy in 22 cats. Biliary or pancreatic adenocarcinoma was diagnosed by histopathology in six cats and one cat had an undiagnosed mass in the common bile duct. The remaining 15 cats had at least one of a complex of inflammatory diseases including pancreatitis, cholangiohepatitis, cholelithiasis and cholecystitis. The most common clinical signs were jaundice, anorexia, lethargy, weight loss and vomiting. Hyperbilirubinaemia was present in all cases. Distension of the common bile duct and gall bladder was the most commonly observed finding on abdominal ultrasound. Nineteen cats underwent exploratory laparotomy for biliary decompression and diversion. Mortality in cats with underlying neoplasia was 100 per cent and, in those with non-neoplastic lesions, was 40 per cent. Long-term complications, in those that survived, included recurrence of cholangiohepatitis, chronic weight loss and recurrence of obstruction. Based on these findings, the prognosis for EHBO in cats must be considered guarded. [source]

Identification of focal adenomyosis as a uterine lesion in two dogs

JOURNAL OF SMALL ANIMAL PRACTICE, Issue 8 2001
N. M. Stöckun-Gautschi
A focal uterine adenomyosis is described in two bitches. In both cases, the uterus showed knobbly enlargements of 4 to 8 cm in diameter, which resulted in distinct clinical symptoms. Other pathological changes of the uterus were not present. One bitch was presented because of a history of vaginal discharge of several months' duration. Radiographs, as well as ultrasonography, revealed a soft tissue lesion at the cervix. The other bitch showed a marked reduction In its general condition and a sudden onset of a tense abdomen. Radiologically, a lesion of soft tissue opacity was observed in the mid-abdomen and was seen to originate from the left uterine horn during exploratory laparotomy. A torsion of the lesion was present, which explained the clinical signs in this second case. [source]

Concentrated preoperative radiotherapy for resectable gastric cancer: 20-years follow-up of a randomized trial

JOURNAL OF SURGICAL ONCOLOGY, Issue 2 2002
Vitali Skoropad MD
Abstract Background and Objectives The role of radiation therapy in resectable gastric cancer is questionable. To study the value of concentrated preoperative radiotherapy, a randomized clinical trial had been carried out. Methods From 1974 to 1978, 152 patients were randomized and underwent exploratory laparotomy; in 50 patients curative surgery was not possible, while 102 patients satisfied protocol requirements and entered in the trial. Patients in the experimental group were treated with preoperative radiotherapy (20 Gy/5 days) and subtotal or total gastrectomy. Patients in the control group underwent surgery alone. Results Study showed acceptable tolerance of radiotherapy regime with no increase of postoperative mortality and morbidity. There was no significant difference in survival between the two treatment groups (,2,=,0.349, df,=,1, P,=,0.555). Subset analysis also failed to demonstrate significant survival advantages of the combined treatment; however, some positive trends were seen in patients with locally advanced gastric cancer. Conclusions Concentrated preoperative radiotherapy in the dose of 20 Gy is safe and feasible, but seems to be insufficient to improve survival in gastric cancer patients. However, the results are promising in selected subgroups of patients, which encourages future trials with adjuvant radiation therapy. J. Surg. Oncol. 2002;80:72,78. © 2002 Wiley-Liss, Inc. [source]

Diaphragmatic hernia in horses: 44 cases (1986,2006)

JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 4 2009
Samantha K. Hart BVMS (Hons)
Abstract Objectives , To present a case series of horses diagnosed with diaphragmatic hernia, and to determine the significance of (1) historical information, examination findings, and laboratory data; and (2) exploratory laparotomy or necropsy findings on short- and long-term outcome. Setting , University Referral Hospital. Design , Retrospective study. Animals , Forty-four horses/foals admitted between 1986 and 2006 with a diagnosis of diaphragmatic hernia made either at exploratory laparotomy or necropsy. Interventions , None. Measurements and Main Results , Information from the medical records included history, clinical examination findings at presentation, and findings of exploratory laparotomy or necropsy. Logistic regression or the Fisher exact test was used to determine factors associated with survival. Outcome was defined as survival to discharge (short-term survival), and long-term survival was defined as horses alive at least 1-year post surgery. Of the 44 horses, 18 died or were euthanized before surgery. Twenty-six were taken to surgery, 17 were euthanized. Nine horses recovered from anesthesia, 7 of which survived to hospital discharge. Of these, 5 were alive at long-term follow-up. Survival was significantly associated with the age of the horse (,2 y old) at presentation, presence of normal peritoneal fluid at presentation, amount of compromised viscera at surgery (<50% small intestine), and the size (<10 cm) and location (ventral) of the diaphragmatic tear. Conclusion , This study confirms that size and location of the lesion do play a significant role in prognosis. And, although the prognosis for horses with diaphragmatic hernia is poor, if horses have operable lesions there is a fair prognosis for long-term survival. [source]

Disseminated candidiasis secondary to fungal and bacterial peritonitis in a young dog

JOURNAL OF VETERINARY EMERGENCY AND CRITICAL CARE, Issue 2 2009
Catherine L. Rogers DVM, DACVECC
Abstract Objective , To describe a severe case of bacterial sepsis and disseminated candidiasis in a previously healthy dog. Case Summary , Fungal sepsis was identified in a 2-year-old dog following intestinal dehiscence 4 days after abdominal surgery. Septic peritonitis was identified at admission and evidence of dehiscence at the previous enterotomy site was found during an exploratory laparotomy. Both gram-positive cocci and Candida albicans were cultured from the abdominal cavity. Candida sp. was also subsequently cultured from a central venous catheter. Euthanasia was performed due to failure to respond to therapy. Fungal organisms, morphologically consistent with Candida spp., were found in the lungs and kidney on postmortem histopathologic examination indicating disseminated candidiasis. New or Unique Information Provided , Candida peritonitis is a well-recognized entity in humans and contributes to morbidity and mortality in critically ill patients. Abdominal surgery, intestinal perforation, presence of central venous catheters, and administration of broad-spectrum antibiotics are all considered to be suspected risk factors. This report describes the first known case of systemic candidiasis occurring secondary to Candida peritonitis and bacterial sepsis in a critically ill dog. [source]

Intestinal Neoplasia in Horses

JOURNAL OF VETERINARY INTERNAL MEDICINE, Issue 6 2006
S.D. Taylor
Background:Intestinal neoplasia of horses is inadequately described. Hypothesis:Intestinal neoplasia of horses has characteristic clinicopathologic features. Animals:Thirty-four horses with intestinal neoplasia. Methods:Retrospective study. Results:Anamnesis, clinical signs, clinicopathologic and pathologic findings in 34 adult horses diagnosed histologically with intestinal neoplasia were reviewed. The horses ranged in age from 2 to 30 years (mean 16.6 years at presentation). The Arabian breed was most represented and there was no sex predisposition. The most common presenting complaints were weight loss, colic, anorexia, and fever. The most consistent clinical signs were poor body condition, tachycardia, tachypnea, fever, and diarrhea. Useful diagnostic tools included rectal examination, routine blood analyses, abdominocentesis, ultrasonographic examination, rectal biopsy, and exploratory laparotomy. Alimentary lymphoma was the most common intestinal neoplasia identified, followed by adenocarcinoma and smooth muscle tumors. The small intestine was the most common segment of intestine affected for all neoplasms. Intestinal neoplasia was diagnosed antemortem in 13 of 34 (38%) horses. The median time from onset of clinical signs to death or euthanasia was 1.9 months. The discharge rate was 15%. Although the longest survival was observed in horses with jejunal adenocarcinoma, all horses were eventually euthanized because of intestinal neoplasia. Conclusions: Arabian horses were 4.5 times more likely to have intestinal neoplasia diagnosed than were other breeds. [source]

Prolonged disease-free survival after orthotopic liver transplantation plus adjuvant chemoirradiation for cholangiocarcinoma

LIVER TRANSPLANTATION, Issue 3 2000
Ilja De Vreede
Orthotopic liver transplantation (OLT) alone for unresectable cholangiocarcinoma is often associated with early disease relapse and limited survival. Because of these discouraging results, most programs have abandoned OLT for cholangiocarcinoma. However, a small percentage of patients have achieved prolonged survival after OLT, suggesting that adjuvant approaches could perhaps improve the survival outcome. Based on these concepts, a protocol was developed at the Mayo Clinic using preoperative irradiation and chemotherapy for patients with cholangiocarcinoma. We report our initial results with this pilot experience. Patients with unresectable cholangiocarcinoma above the cystic duct without intrahepatic or extrahepatic metastases were eligible. Patients initially received external-beam irradiation plus bolus fluorouracil (5-FU), followed by brachytherapy with iridium and concomitant protracted venous infusion of 5-FU. 5-FU was then administered continuously through an ambulatory infusion pump until OLT. After irradiation, patients underwent an exploratory laparotomy to exclude metastatic disease. To date, 19 patients have been enrolled onto the study and have been treated with irradiation. Eight patients did not go on to OLT because of the presence of metastasis at the time of exploratory laparotomy (n = 6), subsequent development of malignant ascites (n = 1), or death from intrahepatic biliary sepsis (n = 1). Eleven patients completed the protocol with successful OLT. Except for 1 patient, all had early-stage disease (stages I and II) in the explanted liver. All patients who underwent OLT are alive, 3 patients are at risk at 12 months or less, and the remaining 8 patients have a median follow-up of 44 months (range, 17 to 83 months; 7 of 9 patients > 36 months). Only 1 patient developed tumor relapse. OLT in combination with preoperative irradiation and chemotherapy is associated with prolonged disease-free and overall survival in highly selected patients with early-stage cholangiocarcinoma. [source]

Complete necrosis of the renal pelvis and ureter after cadaveric renal transplantation

PEDIATRIC TRANSPLANTATION, Issue 1 2000
G. Hidalgo
Abstract: Urological complications of transplantation, in particular, necrosis of the transplanted ureter, are rare. We report on a 20-yr-old boy who received a well-matched cadaveric kidney transplant that was complicated by poor graft function and subsequent exploratory laparotomy for complete necrosis of the renal pelvis and ureter. [source]