Epiploic foramen entrapment in a dog

Area of Science:

• Veterinary Surgery
• Small Animal Internal Medicine
• Diagnostic Imaging

Background:

• Epiploic foramen entrapment is a rare cause of intestinal obstruction in dogs.
• Clinical signs can be vague and mimic other gastrointestinal conditions.

Observation:

• A nine-year-old male castrated Shih Tzu presented with an eight-year history of vomiting and regurgitation, and acute melena, lethargy, anorexia, and anemia.
• Imaging revealed small intestinal displacement and dilation, gastric distention, and peritoneal effusion.
• Exploratory laparotomy confirmed small intestinal herniation through the epiploic foramen with jejunal devitalization.

Findings:

• The dog underwent hernia reduction, jejunal resection and anastomosis, and subsequent decompressive gastrotomy due to persistent gastric atony.
• Postoperative complications included anastomotic dehiscence requiring further surgery.
• Gastric dysmotility gradually resolved with medical management and nutritional support, with the dog clinically normal at three months post-discharge.

Implications:

• Epiploic foramen entrapment should be considered in dogs with persistent vomiting and regurgitation, especially when accompanied by visceral displacement and small intestinal abnormalities on imaging.
• Early surgical intervention is crucial for successful management of this condition.
• This case highlights the complexity of managing postoperative complications and gastric dysmotility associated with intestinal herniation.