Detailed Explanation of Surgical Treatment Methods for Gastric Perforation in Pigs

Cases of gastric perforation in pigs are not commonly seen in clinical practice. The author has encountered two cases: one died due to ineffective treatment following a misdiagnosis, and was confirmed as gastric perforation upon postmortem examination; the other recovered after surgical treatment. The surgically cured case is reported as follows:

1 Clinical Symptoms

A breeding Duroc boar raised by a certain @#@227@#@ specialized household, 6 months old, weighing approximately 75 kg, suddenly became ill on March 23, 2004, showing depression, reduced appetite, abdominal pain and restlessness, frequently lying down, and occasionally vomiting. Palpation of the abdomen elicited a pain response, with abdominal wall tension and groaning from abdominal pain. Respiration was short and rapid at 48 breaths/min, and heart rate was elevated at 88 beats/min. Body temperature was 39°C, with cold extremities. Because the symptoms were extremely similar to the previously misdiagnosed case, abdominal paracentesis was performed with a trocar to aspirate abdominal fluid for examination, which revealed undigested feed residues, raising suspicion of gastric perforation. With the consent of the owner, laparotomy was performed for surgical treatment.

2 Preoperative Preparation

2.1 A mouth gag was used to open the oral cavity, and a stomach tube was inserted to aspirate gastric contents.

2.2 Anesthesia was induced by intramuscular injection of 3 mL of Sumianxin, along with one injection of diazepam.

2.3 The pig was restrained in dorsal recumbency. The surgical site was selected at the ventral midline below the xiphoid cartilage; the area was shaved locally and routinely disinfected for surgery.

2.4 An 18 cm longitudinal incision was made at the surgical site, incising the skin and muscle in sequence, then the peritoneum was cut open to access the abdominal cavity.

2.5 Careful examination revealed a perforation approximately 0.5 cm in diameter in the right pyloric gland region, with blackened surroundings and hyperplastic necrotic tissue. Part of the small intestine on the right abdominal wall was reddened with mild adhesions.

2.6 A large hemostatic forceps was used to clamp and secure the perforation site; the blackened hyperplastic necrotic tissue around the perforation was excised, and silk thread was used for continuous suturing first, followed by inverting sutures.

2.7 The partially adherent small intestine was gently separated with fingers, then the intestinal tract and abdominal cavity were repeatedly lavaged with 0.9% warm sodium chloride solution until thoroughly cleansed, and antibiotics were sprinkled into the abdominal cavity.

2.8 The abdominal cavity was closed. The peritoneum was continuously sutured with silk thread, and the muscle and skin were sutured with interrupted sutures. A drain was placed during closure, an abdominal decompression band was applied, and the surgical site was properly disinfected.

3 Postoperative Care

3.1 The pig was housed in a single pen. The pen was kept clean, dry, and quiet, with clean soft bedding straw placed at the lying area.

3.2 Fresh, easily digestible feed was provided, feeding only to six-tenths of satiety, and clean drinking water was maintained.

3.3 Intramuscular injection of penicillin 4 million IU, streptomycin 2 million IU, and Antongding 20 mL, twice daily for 5 consecutive days.

3.4 The drain was removed 3 days after surgery.

The pig was observed to not eat on the first day after surgery, drinking only a small amount of water; it began eating a small amount on the afternoon of the second day, and gradually improved thereafter. By the fifth day after surgery, spirit and appetite returned to normal. At follow-up two months later, the pig had fully recovered and had successfully been bred twice.

4 Summary

4.1 Cases of gastric perforation in pigs are not commonly seen in clinical practice and are easily confused with diseases such as intestinal constipation, leading to misdiagnosis. If this disease is suspected, abdominal paracentesis can be performed, which will aid in the diagnosis and treatment of this disease.

4.2 The cause of the perforation has not yet been clarified; it may be related to factors such as long-term feeding of highly irritating feed, coarse feed, overfeeding, and movements that cause a sudden increase in intra-abdominal pressure.

4.3 If this disease can be diagnosed early and surgery performed early, it can generally be cured.

4.4 Surgical treatment is of little significance for ordinary pigs, but breeding pigs have higher economic value, so treatment is worthwhile.