Surgery 6: SI Flashcards

(38 cards)

1
Q

What is the blood supply to the SI?

A

Cranial mesenteric

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2
Q

When is dehiscence most likely?

A

2-5 days

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3
Q

How long does it take to regain 80% of strength?

A

2 weeks

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4
Q

What should you do if in doubt about intestinal viability?

A

Remove

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5
Q

What four factors do you use to assess intestine viability?

A

Colour, thickness, blood vessels (thrombosis), peristalsis

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6
Q

What does peristalsis inducate?

A

Probably viable

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7
Q

In a foreign body, where is most of the bruising found

A

Proximal to the FB

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8
Q

Which pattern do you suture the intestine with?

A

Simple continuous (more watertight) starting in healthy tissue

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9
Q

Which material do you suture the intestine with?

A

3-0 or 4-0 PDS

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10
Q

In which situations is short-acting material too short?

A

Lymphoma or damaged tissue

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11
Q

What is the only holding layer in the intestines?

A

Submucosa - so need full thickness bites

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12
Q

What are the indications for enterectomy?

A

Ischaemic bowel, intuss, tumour

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13
Q

What margins do you need for a tumour?

A

3cm

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14
Q

What is the minimum amount of healthy tissue needed?

A

A few mm

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15
Q

How do you ligate the blood vessels for an enterectomy?

A

Double ligate and cut (one close to intestine, one further away)

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16
Q

Which suture pattern do you use for an enterectomy?

A

Full thickness apposition pattern

17
Q

Why do you not suture an enterctomy all the way around?

A

Forms a purse string

18
Q

How do you line up an enterectomy?

A

Put two sutures at the start

19
Q

What do you do if there is a luminal size disparity?

A

Cut smaller side on diagonal or do a “fishmouth” (triangle of tissue)

20
Q

What is the indication for “serosal patching”?

A

For previous dehiscence - stitch wall of another part of intestine over the site

21
Q

What happens if you remove over 80% of the SI?

A

Small bowel syndrome - bacterial overgrowth and chronic diarrhoea

22
Q

Where are linear FBs found in cats?

23
Q

Where are linear FBs found in dogs?

24
Q

Where are the perforations in a linear foreign bosy?

A

Along mesenteric border

25
What can a distended SI be mistaken for on radiography?
Normal LI
26
When should you start to feed after a GA?
Until fully recovered
27
What should the starvation period be for LI surgery?
Long, with low residue diet.
28
Do you do an enema for LI surgery?
No - solid faeces easier
29
Do you give routine antibiotics for LI surgery?
Yes
30
Why is LI healing slower?
More collagenase, poor blood supply, more mechanical stress
31
How common is vomiting with LI issues?
Not
32
What are more likely LI symptoms?
Tenesmus, dyschezia, haematochezia, diarrhoea, constipation
33
Why is ultrasound less useful for the LI?
Gas artefacts
34
What approach do you use if doing caudal surgery on the LI?
Pelvic symphysiotomy or osteotomy
35
When is the only time you do a colotomy?
Biopsy
36
How much of the colon can you resect?
All
37
When might you resect the whole colon?
megacolon
38
How can you prevent incontinence following rectal resection?
Save the last 1-2cm if possible, avoid damaging the nerve supply