Multicenter retrospective evaluation of ileocecocolic perforations associated with diagnostic lower gastrointestinal endoscopy in dogs and cats
Abstract Background Ileoscopy is increasingly performed in dogs and cats with gastrointestinal signs, but iatrogenic ileocecocolic (ICC) perforations have not been described. Hypothesis/Objectives To characterize endoscopic ICC perforations in dogs and cats. Animals Thirteen dogs and 2 cats. Methods...
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| Format: | Article |
| Language: | English |
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Wiley
2020-03-01
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| Series: | Journal of Veterinary Internal Medicine |
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| Online Access: | https://doi.org/10.1111/jvim.15731 |
| _version_ | 1818983435148984320 |
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| author | Vanessa L. Woolhead Jacqueline C. Whittemore Sarah A. Stewart |
| author_facet | Vanessa L. Woolhead Jacqueline C. Whittemore Sarah A. Stewart |
| author_sort | Vanessa L. Woolhead |
| collection | DOAJ |
| description | Abstract Background Ileoscopy is increasingly performed in dogs and cats with gastrointestinal signs, but iatrogenic ileocecocolic (ICC) perforations have not been described. Hypothesis/Objectives To characterize endoscopic ICC perforations in dogs and cats. Animals Thirteen dogs and 2 cats. Methods This is a retrospective case series. Signalment, presentation, endoscopic equipment, colonic preparation, endoscopist's experience level, ileal intubation technique, method of diagnosis, perforation location, histopathology, management, and outcome data were collected and reviewed. Results Six ileal, 5 cecal, and 4 colonic perforations were identified between 2012 and 2019. Dogs weighed 2.4‐26 kg (median, 10.3 kg) and cats 4.6‐5.1 kg (median, 4.9 kg). Endoscopy was performed in dogs presented for vomiting (n = 4), as well as large (n = 5), mixed (n = 4), and small (n = 1) bowel diarrhea. Cats had large bowel diarrhea. Endoscopists included 1 supervised intern, 9 supervised internal medicine residents (2 first year, 6 second year, 1 third year), and 5 internal medicine diplomates. Diagnosis was delayed in 5 dogs, occurring 1‐5 days after endoscopy (median, 3 days); dogs were presented again with inappetence (n = 4), lethargy (n = 4), abdominal pain (n = 3), retching (n = 2), and syncope (n = 1). All animals underwent surgical correction. Histopathology did not identify lesions at the perforation site in any animal. Two dogs required a second surgery; 1 died 12 hours after surgery. Survival to discharge was 93%, with 78% surviving ≥8 months. Conclusions and Clinical Importance Iatrogenic endoscopic ICC perforation is not indicative of underlying disease and is associated with a good prognosis. Delayed diagnosis can occur. Therefore, perforation should be considered in the differential diagnosis for animals with clinical deterioration after endoscopy. |
| first_indexed | 2024-12-20T18:03:04Z |
| format | Article |
| id | doaj.art-2ed692d91c45485ca8dbc732226e9285 |
| institution | Directory Open Access Journal |
| issn | 0891-6640 1939-1676 |
| language | English |
| last_indexed | 2024-12-20T18:03:04Z |
| publishDate | 2020-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of Veterinary Internal Medicine |
| spelling | doaj.art-2ed692d91c45485ca8dbc732226e92852022-12-21T19:30:36ZengWileyJournal of Veterinary Internal Medicine0891-66401939-16762020-03-0134268469010.1111/jvim.15731Multicenter retrospective evaluation of ileocecocolic perforations associated with diagnostic lower gastrointestinal endoscopy in dogs and catsVanessa L. Woolhead0Jacqueline C. Whittemore1Sarah A. Stewart2Department of Clinical Science and Services Queen Mother Hospital for Animals, The Royal Veterinary College London UKDepartment of Small Animal Clinical Sciences University of Tennessee Knoxville Tennessee USADepartment of Clinical Science and Services Queen Mother Hospital for Animals, The Royal Veterinary College London UKAbstract Background Ileoscopy is increasingly performed in dogs and cats with gastrointestinal signs, but iatrogenic ileocecocolic (ICC) perforations have not been described. Hypothesis/Objectives To characterize endoscopic ICC perforations in dogs and cats. Animals Thirteen dogs and 2 cats. Methods This is a retrospective case series. Signalment, presentation, endoscopic equipment, colonic preparation, endoscopist's experience level, ileal intubation technique, method of diagnosis, perforation location, histopathology, management, and outcome data were collected and reviewed. Results Six ileal, 5 cecal, and 4 colonic perforations were identified between 2012 and 2019. Dogs weighed 2.4‐26 kg (median, 10.3 kg) and cats 4.6‐5.1 kg (median, 4.9 kg). Endoscopy was performed in dogs presented for vomiting (n = 4), as well as large (n = 5), mixed (n = 4), and small (n = 1) bowel diarrhea. Cats had large bowel diarrhea. Endoscopists included 1 supervised intern, 9 supervised internal medicine residents (2 first year, 6 second year, 1 third year), and 5 internal medicine diplomates. Diagnosis was delayed in 5 dogs, occurring 1‐5 days after endoscopy (median, 3 days); dogs were presented again with inappetence (n = 4), lethargy (n = 4), abdominal pain (n = 3), retching (n = 2), and syncope (n = 1). All animals underwent surgical correction. Histopathology did not identify lesions at the perforation site in any animal. Two dogs required a second surgery; 1 died 12 hours after surgery. Survival to discharge was 93%, with 78% surviving ≥8 months. Conclusions and Clinical Importance Iatrogenic endoscopic ICC perforation is not indicative of underlying disease and is associated with a good prognosis. Delayed diagnosis can occur. Therefore, perforation should be considered in the differential diagnosis for animals with clinical deterioration after endoscopy.https://doi.org/10.1111/jvim.15731cecumcoloncolonoscopycomplicationileoscopyileum |
| spellingShingle | Vanessa L. Woolhead Jacqueline C. Whittemore Sarah A. Stewart Multicenter retrospective evaluation of ileocecocolic perforations associated with diagnostic lower gastrointestinal endoscopy in dogs and cats Journal of Veterinary Internal Medicine cecum colon colonoscopy complication ileoscopy ileum |
| title | Multicenter retrospective evaluation of ileocecocolic perforations associated with diagnostic lower gastrointestinal endoscopy in dogs and cats |
| title_full | Multicenter retrospective evaluation of ileocecocolic perforations associated with diagnostic lower gastrointestinal endoscopy in dogs and cats |
| title_fullStr | Multicenter retrospective evaluation of ileocecocolic perforations associated with diagnostic lower gastrointestinal endoscopy in dogs and cats |
| title_full_unstemmed | Multicenter retrospective evaluation of ileocecocolic perforations associated with diagnostic lower gastrointestinal endoscopy in dogs and cats |
| title_short | Multicenter retrospective evaluation of ileocecocolic perforations associated with diagnostic lower gastrointestinal endoscopy in dogs and cats |
| title_sort | multicenter retrospective evaluation of ileocecocolic perforations associated with diagnostic lower gastrointestinal endoscopy in dogs and cats |
| topic | cecum colon colonoscopy complication ileoscopy ileum |
| url | https://doi.org/10.1111/jvim.15731 |
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