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Small animal surgery I > Spleen, Liver, Kidney > Flashcards

Spleen, Liver, Kidney Flashcards

(78 cards)

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1
Q

What artery supplies the spleen?

A

Celiac to splenic artery

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2
Q

What are some functions of the spleen?

A

Hematopoiesis, reservoir for RBCs and platelets, immunologic function

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3
Q

What are some splenic surgeries that are used?

A

Splenorrhaphy (rare), partial splenectomy, complete splenectomy

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4
Q

How do you close for a splenorrhaphy?

A

interrupted horizontal mattress for capsule with 4 or 5-0 absorbable monofilament

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5
Q

When is a partial splenectomy indicated?

A

Focal, benign diseases : abscess, laceration, partial infarction

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6
Q

How do you close for a partial splenectomy?

A

Suture capsule with double continuous pattern, TA stapler, CO2 laser, electrosurgery device

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7
Q

When is a complete splenectomy indicated?

A

Severe trauma, torsion, neoplasia, diffuse disease, immune-mediated disease

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8
Q

In emergent cases, how do you ligate the hilar vessels associated with the spleen?

A

Rapid 3 clamp technique

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9
Q

How do you surgically approach the spleen?

A

Ventral midline celiotomy

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10
Q

What are some post-op complications with the spleen?

A

Cardiovascular compromise, DIC

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11
Q

T/F: Benign and malignant tumors of the spleen can be differentiated best by abdominal ultrasound

A

False

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12
Q

What are some CxS seen with splenic neoplasia?

A

Inappetence, weakness, non-specific

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13
Q

What is the most common splenic tumor in dogs?

A

Hemangiosarcoma. Locally invasive, highly metastatic

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14
Q

What is the best way to treat hemangiosarcoma?

A

Surgery with Chemotherapy

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15
Q

What will you see with splenic torsion?

A

Vomiting, CV signs, weakness, anemia, hematuria, icterus

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16
Q

What is the most used diagnostic imaging tool for splenic torsion? What do you see?

A

Ultrasound. Absence of blood flow in hilar region

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17
Q

T/F: Before removing the spleen in a splenic torsion case, you want to untorse the spleen before the splenectomy.

A

False. DO NOT UNTORSE

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18
Q

What is the most common source of splenic trauma?

A

Hit by car

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19
Q

T/F: Surgery is the most indicated source of treatment for splenic trauma

A

False. Most cases can be managed conservatively

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20
Q

What arteries supply the right lobe of the pancreas? The left? The body?

A

Right - cranial/caudal pancreaticoduodenol artiers

Left - splenic artery

Body - hepatic artery

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21
Q

Which part of the pancreas takes up 98% of its mass? What is its function?

A

Exocrine pancreas. Makes digestive enzymes

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22
Q

What are some surgical techniques done on the pancreas?

A

Partial/complete pancreatectomy, pancreatic drainage

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23
Q

What methods can you use to get a biopsy of the pancreas?

A

Guillotine

Lobar dissection

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24
Q

When is a partial pancreatectomy indicated?

A

To remove a tumor, biopsy a large lesion

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25
How do you perform a partial pancreatectomy?
Incise the capsule, dissect between lobules
26
T/F: total pancreatectomies are never performed
True
27
What is a pancreatic pseudocyst?
Collection of secretions and debris in a non-epithelialized sac. Diagnosed with ultrasound
28
What are the 3 options for treating pancreatic pseudocysts?
US guided aspiration, surgical resection, debridement and drainage
29
What typically occurs as sequela to pancreatitis?
Abscesses
30
How do you treat pancreatic abscesses?
Emergency surgery - debridement and omentalization
31
What is the most common pancreatic cancer in dogs and cats?
Exocrine pancreatic adenocarcinoma
32
T/F: EPA is highly malignant, locally invasive, and early to metastasize
True. Extremely poor prognosis
33
Where can a gastrinoma originate from?
Pancreas, duodenum, peripheral lymph nodes, mesentery
34
what % of cases already have metastasis by the time gastrinomas are diagnosed?
70%
35
How do you diagnose gastrinoma
Fasting gastrin serum concentrations
36
What CxS will you see with insulinomas?
weakness, seizures, collapse
37
How can you identify an insulinoma to diagnose?
Ultrasound, CT
38
How do you surgically treat insulinomas?
Resect all affected tissue
39
How do you stage insulinomas?
Biopsy regional lymph nodes and liver
40
What complications can occur with treatment of insulinomas?
Persistent hypoglycemia, hyperglycemia, pancreatitis
41
How many lobes does the liver have?
6
42
What arteries supply the liver?
Hepatic (20%), portal vein (80%)
43
What are some surgical procedures done with the liver?
Biopsy, partial/complete lobectomy
44
T/F: Multiple samples from multiples lobes are ideal with the liver
True
45
What are some methods of obtaining liver biopsies?
Guillotine, punch, laparascopy, tru-cut, FNA
46
What suture material do you use for a guiliotine biopsy?
3-0 absorbable
47
What are the indications for a guillitine biopsy of the liver?
lesions at peripheral, generalized disease
48
What are the indications for a punch biopsy of the liver?
Superficial lesions, generalized disease
49
T/F: FNA of the liver has the best diagnostic yield
False. Poor
50
How do you perform a complete liver lobectomy?
Place a ligature at the base of the lobe and resect
51
T/F: Complete liver lobectomies are only good for small dogs and cats on their left lateral and medial liver lobes
True
52
Which technique, stapler or sutures, do surgeons most common use for liver lobectomies?
Stapler
53
What is the biggest complication with liver surgery?
Hemorrhage, accidental ligation of portal veins and ducts
54
What is the most common form of neoplasia in the liver?
Metastatic
55
What are the 3 forms of adenocarcinomas in the dog liver?
Massive, nodular, diffuse
56
Which of the 3 forms of adenocarcinomas in the dog liver has the best prognosis? Worst?
Best - massive | Worst - diffuse
57
Where are cholangiocellular tumors located?
Intrahepatic
58
What is the most common malignant liver tumor in cats?
Carcinoma
59
What CxS will you see with liver trauma?
Acute blood loss
60
What can the pringle maneuver be used to control?
Hemorrhage of the liver, but only for short spurts at a time
61
What are two biliary surgeries performed?
Cholecystectomy, biliary stenting
62
When is a cholecystectomy indicated?
Mucocele, necrosis, cholangitis, lithiasis, neoplasia, trauma
63
What can cause biliary mucoceles?
Hypothyroidism, hyperadrenocorticism
64
What are the most common CxS seen with biliary mucoceles?
Vomiting, anorexia, lethargy
65
What are some things to cover when doing a cholecstectomy?
Ensure the common bile duct is working, collect bile for a culture, save gallbladder for histo
66
What procedure is used to remove stones and sludge from the gall bladder?
Choledochotomy
67
What does bile duct stenting do?
Promotes patency to the common bile duct
68
When is bile duct stenting most indicated?
Severe pancreatitis
69
When is biliary diversion indicated?
Irreparable trauma to the common bile duct
70
How large does the stoma need to be for a cholecystoduodenostomy?
3 cm
71
What are the most common portosystemic shunt types in small animal patients?
Congenital, single, extrahepatic
72
What CxS will you see with PSS on a cat?
Aggression, pytalism
73
What will you see on cytology of the urine with PSS?
Ammonium biurate crystals
74
What will you see on rads with PSS?
Microhepatica, enlarged kidneys
75
What molecule is used or nuclear scintigraphy of the PSS?
technetium pertechnetate 99
76
T/F: CT angiography is the most recommended test to run for PSS
True
77
When should you give medically treat for PSS?
At least 2 weeks before surgery, reduce diet, lactulose, antibiotics
78
T/F: Poor medical response is a sign of poor prognosis with PSS
True

Small animal surgery I (8 decks)

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