Limited approach to the right flank for placement of a duodenostomy tube.

A new enterostomy tube placement technique is described for provision of nutrients into the duodenum. Placement of the duodenostomy tube (d-tube) is performed through a limited right flank approach under sedation and local anesthesia. Seven client-owned animals (three dogs and four cats) requiring enteral nutritional support were selected for d-tube placement. Patients were fed via the d-tube for two to 28 days. Complications included discomfort when manipulating and exteriorizing the duodenum, discomfort with bolus feedings, local cellulitis, and tube site infection. All complications resolved without further incident. This technique should be considered in patients that are not good candidates for prolonged general anesthesia or esophageal or gastric feeding, or patients being mechanically ventilated.

Surgical repair of nasopharyngeal stenosis in a cat using a stent.

An intraluminal stent was used to maintain patency of a recurrent nasopharyngeal stenosis (NPS) in a cat. The stenotic membrane within the nasopharynx was resected, and a 2-cm long, braided-wire endoprosthesis was placed as a stent. The patient was evaluated at one day, six weeks, 19 weeks, and 49 weeks following surgery. The cat tolerated the stent well. The 19-week recheck revealed granulation tissue partially obstructing the pharyngeal aspect of the stent which was subsequently surgically resected. Complications after excision of the granulation tissue included intermittent upper respiratory congestion and nasal discharge. The 49-week recheck showed no increased granulation tissue; however, upper respiratory congestion was still present. This particular stent, and its use as described in this paper, is recommended in cases of chronic recurrent NPS.