Basics of Rectal Tears Flashcards Preview

Equine Medicine > Basics of Rectal Tears > Flashcards

Flashcards in Basics of Rectal Tears Deck (23):
1

Rectal Tears causes

palpation***
giving enemas
dystocia
chronic impaction
breeding injuries
spontaneous rupture

2

best way to avoid Rectal Tears

don't force against a contraction

3

who is predisposed to Rectal Tears

arabians
ponies, small breedds
fractious horses
colic horses****

4

Ways to avoid Rectal Tears

appropriate restraint like stocks, sedation, and twitches
lube
sedation

5

Classification of rectal tears

1. only muc/submucosa
2. only muscularis
3. muc/sub/muscularis
4. all the way through

6

How are grade 3A and 3B differnt Rectal Tears?

A. leaves serosa intact = serosal diverticulum
B. into the mesentery (dorsally) which is in the retro-peritoneal space

7

what is a complication of the grade 2 rectal tear?

prolapsing muc/submucosa causes a site for fecal impaction.

8

what are typical locations for Rectal Tears?

parallel to long axis.
dorsal rectum, 15-55 cm in

9

What are clinical signs of Rectal Tear?

release of pressure
can palpate things directly now.
large amount of blood on the sleeve
rectum relaxes while horse is straining
2 hours later - peritonitis and endotoxic shock

10

How do you dx a grade 1 rectal tear?

feels like a flap

11

how do you dx a grade 3 Rectal Tears?

rigid and thick edges and seperated

12

Other ways than palpation to dx rectal tears?

(sedate to prevent further damage - epidural or sedation)
endoscopy
abdominocentesis - rule out septic peritonitis

13

What is initial treatment for Rectal Tears?

1. minimizing what you can - pull out feces, get ready to refer
2. AM - Pen/Gent/Metron
3. FLinixin Meglumine (anti-inflamm/anti-endotoxin)
4. laxatives to soften
5. FLuids - hypertonic followed by isotonic colloids at shock dose
6. rectal packing
7. Reduce rectal activity - epidural anesthesia and catheter not to exceed 10 mls of mepiv

14

What is sufficient treatment for grade 1 and 2 Rectal Tears?

AB, Laxatives (mineral oiL), and dietary changes

15

why do we do rectal packing?

prevent progression to gr 3 or 4
prevent fecal cont

16

How do we rectally pack?

put 3 inch stockinette with cotton and poviodine/lubed gel 10 cm proximal to the tear
purse-string the anus closed.
then reduce activity of the rectum

17

when do we turn to surgical management? and what is the goal?

when GR 3 or 4
turn feces away from tear

18

surgical procedure for rectal tears

loop colostomy (will need reversal) - we do double incision

prepare the loop in the upper incision
make lower 8 cm incision and have loop so that the antimesenteric side can be incised.

19

Aftercare for surgery

AB
laxatives
petroleum-ointment around the stoma

20

Reversal for the colostomy

requires anesthesia and all that, then anastomose the small colon

21

What can be done as adjunct to gr 3 rectal tear?

suture repair.

22

prognosis of grade 1 tears

93%

23

prognosis os grade 3 tears

60%
3A - 74
3B - 44