Colic Decision Making Flashcards Preview

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Flashcards in Colic Decision Making Deck (31):
1

Give 2 examples of simple colics

Spasmodic, impaction

2

Give 3 examples of potentially complicated colic

Displacement, enteritis, colitis

3

What is a definitive surgical colic?

Strangulating lesion

4

What is a common cause of non-GI colic?

Pariparturient mare uterus

5

What are 3 general causes of abdominal pain?

- Distension (MECHANICAL: gas, fluid, ingesta or FUNCTIONAL)
- Inflammation/ischaemia of intestine
- Irritation of peritoneum

6

What are the 2 forms of mechanical obstruction?

- Non-strangulating eg. impaction , displacement
- Strangulating eg. volvulus, torsion, incarceration

7

Where are impactions usually seen?

- pelvic flexure and RDC -> thin transverse colon flexure

8

Where are displacements usually seen

LI

9

What are functional obstructions?

Motility (paralytic) dysfunction - ileus etc. [blood supply not compromised]
- Enteritis, grass sickness [equine dysautonomia], post-surgical ileus

10

What are cuases of inflammation? Are these strangulating?

Enteritis, colitis, typhlitis, peritonitis

11

What are causes of ischaemia?

- Volvulus, torsion, incarceration
- Thrombotic
- Parasitic [migrating strongylus vulgaris larvae, coagulopathy, DIC] <- rarely seen now due to Ivermectin success, incidence may ^ due to resistence

12

Outline the 6 non-strangulating lesions that may cause colic

- Spasmodic colic
- Impaction
- Displacement
- Enteritis/ileus
- Typhocolitis
- Peritonitis

13

In horses where does the cause of diarrhoea ALWAYS originate?

LI

14

How do SI pathologies manifest?

Spontaneous reflux

15

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)

16

Give 7 causes of strangulating lesions of the SI to cause colic. Which is most common? Which is rare?

1. Volvulus (root of mesentry)
2. Strangulating lipoma [most common]
3. Epiploic foramen entrapment [R abdo between portal V and caudal vena cava]
4. Inguinal/scrotal hernia
5. Intussusceptions
6. Diaphragmatic hernia [rare]
7. Mesenteric rent

17

Give 2 causes of strangulating lesions of the LI to cause colic. How serious are these problems?

1. Colon torsion - very severe colic.
2. Intussusception
- Ceaco-colic
- Ileo-ceacal
- Ceaco-ceacal

18

What clinical signs distinguish SI lesions?

- reflux (though may be absent)
- Distended SI (palpable on rectal, ultrasound)

19

What clinical signs distinguish LI lesions?

± abdo distension
- impaction/gas accumulation palpable on rectal
- distension of LI palpable on rectal
- no reflux (usually)

20

Give 2 SI conditions requiring medical Tx

- Enteritis/ileus
- Grass sickness

21

Give 7 conditions requiring surgical Tx

- Volvulus (root of mesentry)
- Strangulating lipoma
- Epiploic foramen entrapment
- Inguinal/scrotal hernia
- Intussusceptions
- Diaphragmatic hernia
- Mesenteric rent

22

How is grass sickness Dx?

Biopsy (ileal?)

23

Give 6 LI conditions requiring medical Tx

- Spasmodic colic
- Impaction
- Left dorsal displacement
- Right dorsal displacement
- Colitis
- Typhlocolitis

24

Give 2 LI conditions requiring surgical Tx

- Colon torsion
- Non-resolving displacement and impactions

25

In what situations should a colic be referred?

- SI lesions (Sx likely, medical cases need intense Tx)
- Conditions requiring intensive medical Tx (enteritis/colitis)
- Non-resolving impactions (IV fluids, surgery if displaced)
- Recurring/chronic colic for further work up

26

How much does a medical colic cost to treat in referral centres? Surgical colic? Colitis/enteritis?

~ £1000-£3000
~ £4000-£7000
~ £2000-£5000

27

How should referral be decided wrt owner?

- age of horse
- willingness to undergo abdo surgery
- insurance (type of cover, be aware colic may have been removed if suffered previously)

28

SEE LECTURE FOR FINDINGS ON HISTORY, PE, NGT, TX RELATED TO PROGNOSIS ETC.

~

29

What complications can be seen <2-4 weeks post-surgery?

- aneasthetic complications (1/100 die)
- post-op colic
- post-op ileus (reflux)
- incisional complications (dehiscence, infection)
- thrombosis
- peritonitis
- laminitis

30

What complications can be seen >2-4 weeks post-surgery?

- recurrent/chronic colic due to adhesions
- Incisional hernia

31

What are the prognoses for
a) simple medical colic?
b) non-strangulating surgical colic?
c) strangulating SI lesion?
d) strangulating LI lesion?

a) 90% good
b) 70-90% good
c) guarded (without resection 60-80%; with resection 50-70%)
d) guarded/poor (wihtout reseaction 36-83%; with resection[rarely possible] 50-80%)