Key points and precautions for surgical treatment of 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 after ineffective treatment due to misdiagnosis, and was confirmed as gastric perforation by necropsy after death; the other recovered after surgical treatment. The surgically cured case is reported as follows:

1 Clinical symptoms

A breeding Duroc boar, about 6 months old and weighing about 75 kg, was raised by a certain @#@227@#@ specialized household. It suddenly became ill on March 23, 2004, showing depression, decreased appetite, abdominal pain and restlessness, frequently lying down, and sometimes vomiting. Palpation of the abdomen elicited a pain response, the abdominal wall was tense, and it groaned from abdominal pain. Breathing was short and rapid, at 48 times/min, and the heartbeat was accelerated, at 88 times/min. The body temperature was 39°C, and the extremities were cold. Because the symptoms were very similar to those of the previously misdiagnosed case, a trocar was used for abdominal paracentesis, and the abdominal fluid was aspirated for examination. Undigested feed residues were found, and gastric perforation was suspected. With the owner's consent, laparotomy surgery was performed.

2 Preoperative preparation

2.1 Open the oral cavity with a mouth gag, insert a stomach tube, and aspirate the gastric contents.

2.2 Inject 3 mL of Sumianxin intramuscularly for anesthesia, and at the same time inject one dose of diazepam.

2.3 Perform dorsal recumbency restraint. The surgical site is selected on the ventral midline below the xiphoid cartilage; the hair is clipped locally, and routine surgical disinfection is carried out.

2.4 Make an 18 cm long longitudinal incision at the surgical site, incise the skin and muscle in sequence, cut open the peritoneum, and open the abdominal cavity.

2.5 Careful examination revealed a perforation about 0.5 cm in diameter in the right pyloric gland region, with blackening around the perforation and tissue hyperplasia and necrosis. Part of the small intestine on the right abdominal wall was red and mildly adherent.

2.6 Use large hemostatic forceps to clamp and fix the perforation site, excise the blackened, hyperplastic, and necrotic tissue around the perforation, and use silk thread to perform continuous suturing first, followed by inverting sutures.

2.7 Gently separate part of the adherent small intestine with the fingers, then repeatedly flush the intestinal tract and abdominal cavity with 0.9% warm sodium chloride solution until clean, and scatter antibiotics in the abdominal cavity.

2.8 Close the abdominal cavity. Use silk thread for continuous suturing of the peritoneum, and interrupted suturing of the muscle and skin. When closing, create a drain, place an abdominal decompression band, and properly disinfect the surgical site.

3 Postoperative care

3.1 Keep the pig in a single pen. Keep the pen clean, dry, and quiet, and spread clean, soft bedding straw in the lying area.

3.2 Feed fresh, easily digestible feed, feed only until six-tenths full, and keep the drinking water clean.

3.3 Intramuscular injection of penicillin 4 million IU, streptomycin 2 million IU, and Antongding 20 mL, twice a day for 5 d.

3.4 Remove the drain 3 d after surgery.

It was observed that the pig did not eat on the 1st day after surgery and drank only a small amount of water. It began to eat a small amount on the afternoon of the 2nd day, and gradually improved thereafter. By the 5th day after surgery, spirit and appetite returned to normal. Follow-up two months later showed that it had fully recovered and had successfully mated 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 help in the diagnosis and treatment of this disease.

4.2 The cause of the perforation is not yet clear and may be related to factors such as long-term feeding of highly irritating feed, rough feed, overfeeding, and movements that cause a sudden increase in intra-abdominal pressure.

4.3 If this disease can be diagnosed early and operated on early, it can generally be cured.

4.4 For ordinary pigs, surgery is of little significance, but breeding pigs have relatively high economic value, so treatment is worthwhile.