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The dangers of playing on the beach.

Halo is only 8 months old. She presented one Saturday morning looking very sad and subdued. She had vomited twice in the morning. On palpation Dr Jill could feel a thick, hard sausage in her stomach.

Xrays showed a dense intestinal foreign body in her abdomen. Blood tests showed she was dehydrated, but her liver and kidney function was normal.

Halo had an intravenous catheter placed and had a fluid bolus to try to stabilize her condition. It was decided that Halo needed surgery to explore the intestinal blockage. Halo was anaesthetized, her abdomen opened and her intestines examined. The final section of her small intestine had a 15cm hard swelling. The swollen part of the intestine was very red and hard. Given more time, this intestinal section could be come so inflamed it would cause acute peritonitis.

The foreign body was able to be manipulated and it seemed possible to manage it through to the large bowel but this proved impossible. The mass was then massaged back 20 cm to an area of intestine that looked much less inflamed.

The intestine was opened revealing a thick sludge of sand rather than a single object. As much sand as possible was removed and the intestinal incision sutured.

The swollen area of intestine was beginning to look more healthy. The surgery was completed with muscle and skin layers closed.

Halo recovered well.

The following day Halo was very bright after a night on intravenous fluids, antibiotics and pain relief. It was a concern that there might be some sand remaining in her intestine so another xray was taken.

The remaining sand has moved though to her large bowel and can be seen as a white sausage just below her spine. To encourage it to move through she will be given some laxatives for the next few days, but repeat xrays may be needed.

Halo’s owners often play with her on the beach and thought she must be swallowing a lot of sand when she chases the ball. Things might have to change because all the sand she had eaten had caused a sand impaction that had set like concrete.

Sand impaction – an unusual Northern Beaches problem.

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