Flashcards in Surgical Approach to the Large Intestine Deck (24):
What are the different approaches that can be taken to access the LI?
Ventral Midline Laparotomy
What should be done if a FB is in the LI?
Milk it out and only enter the LI if absolutely necessary, it shouldn't be necessary with a LI FB.
What consequences are there of removing:
a) too much of the LI
b) the ileocaecolic junction?
a) Loss of reservoir & absorptive function
Increased faecal frequency
b) Can lead to increased risk of infection of the SI as bacteria can backtrack.
How much LI is removable whilst retaining continence?
6cm (in a Labrador sized dog)
Which suture material should be used for the LI?
What common thing might be seen when stapling the LI to anastamose it?
Post op bleeding/blood on the faeces
What are the complications of colorectal surgery?
Dehisence and SP
Stricture & Tenesmus
How can megacolon be diagnosed?
Colon full of faecal material with dehydration and lack of BC. Need to rule out other causes of constipation first.
How is megacolon treated?
Underlying disease treatment if secondary
-High Fibre, low residue diet
Sugical - subtotal colectomy
What dogs are predisposed to adenocarcinomas of the LI?
Dogs 6-9yo. GSDs, great dane, dobermans, boxers
What historical findings might indicate a LI neoplasia?
increased defecation frequency
ribbon like faeces
How could neoplasia of the LI be diagnosed?
Rectal exam (60-80%)
What types of resection of the colon can be performed?
Submucosal resection - good survival times
Wide surgical excision with intestinal resection and anastamoses.
If there is metasteses of LI neoplasia would resection still be considered?
Yes as it may make the patient more comfortable.
What can cause rectal prolapse?
What is the treatment for rectal prolapse?
low residue diet
stitch to body wall if repeats
What are the anal glands?
Invaginations of the skin
What does the normal anal sac fluid look like?
Outline the treatment for anal sac:
a) manual expression
Catheterise the ducts
Dexmethasone and antibiotics into the gland
Systemic antibiotics if abscess/systemic disease
Yeast treatment if found on cytology
What are the two types of sacculectomy? When would these be performed?
Perform with repeat cases. Open and closed techniques
What are the complications that may occur with sacculectomy?
-Should be fine if one caudal rectal nerve is preserved
-Due to failure to remove all of the tissue
What are the treatments for perianal adenoma and adenocarcinoma?
Adenoma - castration may be sufficient.
Carcinoma - combination of surgery, chemotherapy and radiotherapy
What is anal furunculosis?
Immune mediated attack of skin around the anus.