4.

Question 1

hemoperitoneum can be divided into

Answer 1

Question 2

hemoabdomen clinical signs

Answer 2

• shock
• Pale mm, ↑CRT
• Weak pulses
• Tachycardia
• Cardiac Arrhythmias
• Abdominal distention
• Minimal response to fluid therapy
• Bruising around
  umbilicus

Question 3

average amount of blood in dog and cat

Answer 3

dog : 90 ml/kg
cat: 60 ml/kg

Question 4

clinical signs with 15-30% acute blood loss

Answer 4

resting tachycardia, BP normal

Question 5

clinical signs with 30-40% acute blood loss

Answer 5

hypoperfusion (long CRT, pale), decreased urine output

Question 6

clinical signs with >40% acute blood loss

Answer 6

circulatory collapse, marked hypotension

Question 7

belly wraps should not be used with

Answer 7

• careful with respiratory distress pt and diaphragmatic hernias

Question 8

+ abdominocentesis for hemoabdomen will show

Answer 8

sanguineous nonclotthing fluid with large numbers of RBC
* blind- 50% false negative, need 5-25 ml/kg
* AFAST guided
* can be open or closed technique

Question 9

xrays of hemoabdomen can show

Answer 9

• Loss of abdominal detail
• Small intestinal displacement
• Lack of normal splenic position
• Occasionally gas within the spleen

ultrasound usually more helpful

Question 10

when to bring hemoabdomen to surgery

Answer 10

• Failure to achieve hemodynamic stability of patient
• Evidence of continued bleeding
• Evidence of
  pneumoperitoneum, hernia or mass effect on diagnostic imaging

Question 11

1st organs to check for unknown hemoabdomen

Answer 11

spleen
liver
kidneys/adrenals

Question 12

how to do pringle maneuver

Answer 12

• place index finger through epiploic region into omental bursa
• compress hepatic artery and portal vein
• hold pressure- replace with clamp
• still bleeding= injury to retrohepatic vena cava or hepatic veins

Question 13

where to clamp aorta

Answer 13

just cranial to left adrenal near celiac artery

Question 14

how often to release aortic cross clamp

Answer 14

every 5 minutes
* use non crushing- bulldog or rumel tourniquet

Question 15

what can be used for small volume bleeding

Answer 15

gelfoam
surgicel
collagen mesh
tissue glue
omental packing

Question 16

what blood supply to preserve if removing spleen

Answer 16

• splenic artery branch to left limb of pancreas
• left gastroepiploic artery and short gastric supply the stomach

Question 17

how to do partial liver lobectomy

Answer 17

• finger fracture
• suture tracture
• Stapler or sealing device

Question 18

how to do complete liver lobectomy

Answer 18

double ligation of blood vessels and bilary duct near the hilus

• suture ligation
• stapler
• sealing device

indicated for bleeding masses or irreparable hemorrhage, isolated to a single lobe

Question 19

how to repair renal hemorrhage

Answer 19

• always try direct pressure and to repair capsule
• if that fails remove kidney- ligate artery and vein and ureter seperatly