L13: Basic GI surgery - Small animal Pt.1 (Ellison) Flashcards Preview

Surgery (Spring 2015) > L13: Basic GI surgery - Small animal Pt.1 (Ellison) > Flashcards

Flashcards in L13: Basic GI surgery - Small animal Pt.1 (Ellison) Deck (25):
1

CS of pyloric obstruction

projectile vomiting
undigested without mucus but with bile
rapid fluid loss
electrolyte loss (Na, K, HCl)
alkalosis

2

gastrotomy guidelines

-ventral midline approach
-stay sutures
-b/w lesser and greater curvatures
-use Cushing in submucosa and Lembert in seromuscular-submucosa
-absorbable suture, but no cat gut

3

risk factors for GDV

Great Dane > St. Bernard > Weimeraner > Irish Setter

4

etiologies of GDV

-diet
-overeating, postprandial exercise
-hypogastric ligament stretch
-delayed gastric emptying
-bacterial fermentation
-aerophagia
-hypergastrinemia
-gastric myoelectric dysrhythmias

5

CS of GDV

restless
uncomfortable
hypersalivation
wretching
abd distention
hyperpnea
shock

6

mech. of GDV rotation

fundus L to R
spleen ventral to dorsal
270 degree clockwise rotation (preceeded by dilation)

7

pathophys. of GDV

-venous stasis
-dec. arterial flow
-tearing of short gastric and gastroepiploic a. and v.
dec. pH and pepsin --> ischemia, necrosis, elevated serum lactate
-gastric distention --> compression of portal v. --> intestinal stasis --> septic shock
-dec. production of coag factors 8 and 9 in spleen --> hemorrhage, necrosis, etc.
-2ary DIC

8

tx of GDV

-decompress
-shock therapy
-tx tachycardias with lidocaine bolus
-tx seizure with valium
-80% recur without sx

9

how to assess gastric wall viability

color
temp
peristalsis (pinch test***)
thickness**
fluorescein - not accurate
surface oximetry

10

advantages of tube gastrostomy

rapid easy procedure
creates permanent adhesion
allows for gastric decompression
allows for tube feeding

11

incisional gastropexy

-rapid, easy
-stomach lumen not entered
-disadv: no post-op alimentation, no good follow-up

12

types of gastropexy

tube
incisional
ventral midline

13

types of intestinal obstruction

complete/incomplete
high/low
simple mechanical/strangulated
acute/chronic
perforated/non-perforated

14

simple complete obstruction

-ischemia, devitalization
-dec. fluid absorption
-bowel wall edema
-fluid accumulation

15

3 types of mechanical obstruction

luminal (FB, polypoid mass)
intramural (neoplasia, fungal granuloma)
extramural (adhesions, strangulated (or non?) hernia)

16

>50% secretions from:

Stomach, duodenum, proximal jejunum (most resorbed by jejunum, ileum)

17

duodenal obstruction -->

loss of salivary, gastric, pancreatic duodenal secretions --> rapid dehydration
*in LOW jejunal obstruction, resorptive capacity is maintained*

18

causes of simple complete obstruction

FB
trichobezoars
tumors
granulomas
stricture
enterolith
parasite
adhesion
gas (swallowed or formed in situ)

19

>1.6x midpoint height of L5 is considered dilated for dogs***

indicative of mechanical obstruction

20

methods of experiemental intestinal viability

temp probes
pH monitors
Doppler flow devices
IV vital dyes
surface oximetry

21

methods of clinical intestinal viability***

color
arterial pulsations
peristalsis - pinch test***

22

causes of strangulation obstruction

local pressure necrosis - FB
mesenteric vascular disruption (volvulus, intuss., hernia, thromboembolism)

23

lymphoma on U/S

circumferential symmetric hypoechoic

24

adenocarcinoma U/S

symmetric or asymmetric mixed echogenicity

25

intussusception on U/S

inc. circumference symmetric target