Clinical utility of intraoperative microvascular imaging for determining the extent of intestinal resection in a dog with small intestinal volvulus

Abstract Microvascular imaging (MVI), a novel ultrasonographic technique, enables real‐time visualisation of low‐velocity, pulsatile blood flow without the use of contrast agents. This report describes the case of a 2‐year‐old Pomeranian presenting with acute anorexia and vomiting. Abdominal ultrasonography and contrast‐enhanced computed tomography revealed findings consistent with mesenteric volvulus, prompting emergency laparotomy. Conventional intraoperative assessment suggested that over 50% of the small intestine was non‐viable. However, intraoperative MVI delineated a clear boundary between regions with and without pulsatile mucosal blood flow, allowing for a limited resection of only 11 cm—approximately 7% of the total small intestinal length. Postoperative MVI confirmed stable blood flow around the anastomosis, and the dog recovered uneventfully without developing short bowel syndrome. This case suggests that MVI may provide additional intraoperative information to assist surgical decision making regarding the extent of intestinal resection.