Latissimus Dorsi Muscle Flap-Augmented Closure for Esophageal Perforation in a Dog

摘要

A 2-year-old castrated male Maltese dog weighing 3.48 kg was referred for evaluation of lethargy, dyspnea, and anorexia that had persisted for 5 days. On physical examination, drooling, labored breathing, and depression were identified. Laboratory examination findings included marked leukocytosis and elevated C-reactive protein levels. Survey radiographs revealed pleural effusion and pneumothorax. Contrast esophagograms showed leakage caudal to the base of the heart. Based on these findings, a diagnosis of esophageal perforation was made. Endoscopy was then performed and revealed ingested bone. After a musclesparing thoracotomy through the right fifth intercostal space, the esophageal perforation was identified caudal to the base of the heart. After removal of the foreign body, a 4- x 4.5-cm beef bone fragment, necrotic tissues were minimally removed by surgical debridement. Closure of the esophagus was performed using a double-layer suture pattern and was supported with a latissimus dorsi muscle flap through the fourth intercostal space. An esophagostomy tube was placed for 3 weeks post-operatively. A liquid diet was fed orally for 1 week after esophagostomy tube removal. Clinical signs were resolved, and the dog was discharged 4 weeks post-operatively. There was no evidence of drooling, labored breathing, and regurgitation by 4 months postoperatively. Hence, the latissimus dorsi muscle flap could be considered a useful approach for veterinarians when performing esophagus surgery.