surgery of the perineum, rectum, anus III Flashcards
(33 cards)
what is rectal prolapse
protrusion or eversion of rectal mucosa from the anus
what is signalment of rectal prolapse patients
more common in younger animals
history of rectal prolapse patients
straining, younger animals, parasites and acute enteritis (younger animals)
how is rectal prolapse differentiated from ileocolic intussusception
insertion of finger or probe alongside the prolapsed mass is possible with intussusception, but not with rectal prolapse
medical management of rectal prolapse
manual reduction and placement of purse string suture around anus
what should be done before manual reduction of rectal prolapse
warm saline lavages, massage, lubrication
what should be done after reduction of rectal prolapse
retention enema of several mL of Kaopectate to decrease straining, purse string suture, epidural anesthesia, treat/resolve the cause
how should the purse string suture be applied
tight enough to maintain reduction of prolapse, loose enough to allow passage of soft stool
when should a colopexy be performed
if rectal prolapse repeatedly recurs after manual reduction or amputation
how do you resect the rectum with a probe
make a full thickness incision through the prolapsed tissue 1/3 to 1/2 the distance around the circumference
how is the patient positioned for rectal prolapse
ventral recumbency with hind legs over end of table, pelvis elevated with padding and tail secured over back
why should the end of the table be padded
prevent pressure on femoral nerves
how should the horizontal mattress stay sutures be placed
should enter the rectal lumen with the needle being deflected by the probe before being passed through the rectal tissues again
how should the traumatized tissue be transected?
transect traumatized tissue in stages caudal to stay sutures
after each stage of traumatic tissue resection, how are the transected edges apposed?
anatomically appose transected edges with simple interrupted sutures approximately 2 mm apart and 2mm from cut edge
what is important regarding postop management for rectal prolapse
cause of prolapse must be treated
when should the purse string suture be removed after manual reduction
3-5 days after manual reduction
when should the purse string suture be removed after resection
1-2 days
how long should stool softeners be used after resection
2-3 weeks
what is the prognosis of a rectal prolapse that is chronic without sx?
poor
what is the prognosis of a rectal prolapse with surgery and treatment of the primary cause
good
what is a perianal fistula?
chronically relapsing suppurative, progressive, deep ulcerating tracts in perianal tissues
how are perianal fistulas diagnosed?
exam perineal area to establish tentative dx, histologic exam is necessary to r/o SCC, pythiosis, and other erosive conditions
signalment for perianal fistulas
GSD, males>females (2:1), intact males, rare in cats
