In January 2023, Sherman presented to our emergency department for lethargy and vomiting after eating and drinking that began a couple days prior. His owners tried to give him a bland diet and ice chips, but he would vomit within two to three minutes after eating it. Since Sherman has a history of a sensitive stomach, they didn’t know what was going on. They noted that he ate a large hickory smoked kneecap beef bone around the same time his symptoms started, but his brother, Tyrion, ate the same beef bone and was fine.
Dr. Spry, one of our internal medicine doctors, attempted to remove the bone endoscopically, but she was unsuccessful. His care was transferred to Dr. Andersen, one of our surgeons, to remove the bone piece. Initially an attempt to remove the bone was made via the entrance into his stomach (gastrotomy), but this was unsuccessful, so Sherman underwent chest surgery (thoracotomy). After they removed the bone, his esophagus was visualized and noted to be necrotic as well as perforated. A procedure called an esophageal resection and anastomosis (R&A) was preformed where the necrotic regions of his esophagus were resected, and the healthy esophagus was connected together (anastomosed). A chest tube was then placed and he was started on broad-spectrum antibiotics. A feeding tube (nasogastric tube) was also placed into the stomach to provide oral liquid mediations and to feed him during initial healing of the esophagus.
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