Colic and abdominal surgery in 14-month-old African elephant
Place: South Africa
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A 14-month-old African elephant presented with colic caused by colon obstipation. Due to the severity of the symptoms, it was decided to perform abdominal surgery. A second surgery was required after 3 months.
The animal was anesthetized with etorphin, intubated in the trachea, maintained on isoflurane and positioned in dorsal recumbancy.
A midline incision was elected to approach the intestines. An obstruction of the colon was found and surgically removed.
The peritoneum and muscle layers in the ventral midline were closed in one layer with Number 1 Maxon loop sutures, used in horse colic surgery to close the abdomen. Each suture knot was thrown 5 times, instead of the normal 3 times.
The subcutis was closed with 2/0 Vicryl (continuous sutures) and the skin with Number 1 Nylon (single sutures).
Reaction of the wound occured both times and she developed an incisional infection. This infection was treated by keeping the wound clean and both times the wound finally healed well.
The elephant recovered completely without further complications.
Instead of a midline incision, aparamedian incision can be used, just several centimeters left or right of the ventral midline. The advantage of this approach is the possibility to suture more muscle tissue compared to the connective tissue of the linea alba. There may, however, be more bleeding during surgery and access may be more limited than when a midline incision is used.
Diagram of the closure of a paramedian incision.
B) Abdominal tunic
C) Aponeurosis of the external abdominal oblique muscles
D Rectus abdominal muscle
E) Aponeurosis of the transverse abdominal muscle