Colic Decision Making Flashcards
Give 2 examples of simple colics
Spasmodic, impaction
Give 3 examples of potentially complicated colic
Displacement, enteritis, colitis
What is a definitive surgical colic?
Strangulating lesion
What is a common cause of non-GI colic?
Pariparturient mare uterus
What are 3 general causes of abdominal pain?
- Distension (MECHANICAL: gas, fluid, ingesta or FUNCTIONAL)
- Inflammation/ischaemia of intestine
- Irritation of peritoneum
What are the 2 forms of mechanical obstruction?
- Non-strangulating eg. impaction , displacement
- Strangulating eg. volvulus, torsion, incarceration
Where are impactions usually seen?
- pelvic flexure and RDC -> thin transverse colon flexure
Where are displacements usually seen
LI
What are functional obstructions?
Motility (paralytic) dysfunction - ileus etc. [blood supply not compromised]
- Enteritis, grass sickness [equine dysautonomia], post-surgical ileus
What are cuases of inflammation? Are these strangulating?
Enteritis, colitis, typhlitis, peritonitis
What are causes of ischaemia?
- Volvulus, torsion, incarceration
- Thrombotic
- Parasitic [migrating strongylus vulgaris larvae, coagulopathy, DIC]
Outline the 6 non-strangulating lesions that may cause colic
- Spasmodic colic
- Impaction
- Displacement
- Enteritis/ileus
- Typhocolitis
- Peritonitis
In horses where does the cause of diarrhoea ALWAYS originate?
LI
How do SI pathologies manifest?
Spontaneous reflux
What time frame do you have for saving strangulating lesions?
~ 1 hour = viable intestine (distension of intestine and stomach)
~ 3-4hrs = Compromised intestine (leakage of blood/protein -> abdo, loss of fluid -> intestine [may -> hypovolaemic shock])
~ 6-8hrs = Dead intestine (absorption of toxins -> blood)
Give 7 causes of strangulating lesions of the SI to cause colic. Which is most common? Which is rare?
- Volvulus (root of mesentry)
- Strangulating lipoma [most common]
- Epiploic foramen entrapment [R abdo between portal V and caudal vena cava]
- Inguinal/scrotal hernia
- Intussusceptions
- Diaphragmatic hernia [rare]
- Mesenteric rent
Give 2 causes of strangulating lesions of the LI to cause colic. How serious are these problems?
- Colon torsion - very severe colic.
- Intussusception
- Ceaco-colic
- Ileo-ceacal
- Ceaco-ceacal
What clinical signs distinguish SI lesions?
- reflux (though may be absent)
- Distended SI (palpable on rectal, ultrasound)
What clinical signs distinguish LI lesions?
± abdo distension
- impaction/gas accumulation palpable on rectal
- distension of LI palpable on rectal
- no reflux (usually)
Give 2 SI conditions requiring medical Tx
- Enteritis/ileus
- Grass sickness
Give 7 conditions requiring surgical Tx
- Volvulus (root of mesentry)
- Strangulating lipoma
- Epiploic foramen entrapment
- Inguinal/scrotal hernia
- Intussusceptions
- Diaphragmatic hernia
- Mesenteric rent
How is grass sickness Dx?
Biopsy (ileal?)
Give 6 LI conditions requiring medical Tx
- Spasmodic colic
- Impaction
- Left dorsal displacement
- Right dorsal displacement
- Colitis
- Typhlocolitis
Give 2 LI conditions requiring surgical Tx
- Colon torsion
- Non-resolving displacement and impactions
