Surgical Approach to the Large Intestine Flashcards Preview

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Flashcards in Surgical Approach to the Large Intestine Deck (24):
1

What are the different approaches that can be taken to access the LI?

Ventral Midline Laparotomy
Pelvic Split
Transanal

2

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.

3

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.

4

How much LI is removable whilst retaining continence?

6cm (in a Labrador sized dog)

5

Which suture material should be used for the LI?

PDS II

6

What common thing might be seen when stapling the LI to anastamose it?

Post op bleeding/blood on the faeces

7

What are the complications of colorectal surgery?

Dehisence and SP
Wound infeciton
Abscess formation
Faecal incontinence
Stricture & Tenesmus
Rectal prolapse
Heamatochezia

8

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.

9

How is megacolon treated?

Underlying disease treatment if secondary
Medical:
-Enemas
-Prokinetics
-Laxatives
-High Fibre, low residue diet
-Increase walks
Sugical - subtotal colectomy

10

What dogs are predisposed to adenocarcinomas of the LI?

Dogs 6-9yo. GSDs, great dane, dobermans, boxers

11

What historical findings might indicate a LI neoplasia?

weight loss
tenesmus
heamatochezia
increased defecation frequency
rectal prolapse
ribbon like faeces

12

How could neoplasia of the LI be diagnosed?

Rectal exam (60-80%)
Radiography
Ultrasound
Colonoscopy

13

What types of resection of the colon can be performed?

Submucosal resection - good survival times
Wide surgical excision with intestinal resection and anastamoses.

14

If there is metasteses of LI neoplasia would resection still be considered?

Yes as it may make the patient more comfortable.

15

What can cause rectal prolapse?

Parasites
Rectal neoplasia
Perineal hernias

16

What is the treatment for rectal prolapse?

anthelmintics
faecal softeners
low residue diet
sedatives

stitch to body wall if repeats

17

What are the anal glands?

Invaginations of the skin

18

What does the normal anal sac fluid look like?

Liquid brown

19

Outline the treatment for anal sac:

a)Impaction

b)Sacculitis/Abscess

a) manual expression

b)Sedate/aneasthatise
Catheterise the ducts
Collect samples
Lavage
Dexmethasone and antibiotics into the gland
Systemic antibiotics if abscess/systemic disease
Yeast treatment if found on cytology

20

What are the two types of sacculectomy? When would these be performed?

Perform with repeat cases. Open and closed techniques

21

What are the complications that may occur with sacculectomy?

Faecal incontinence
-Should be fine if one caudal rectal nerve is preserved
Persistent infection
-Due to failure to remove all of the tissue

22

What are the treatments for perianal adenoma and adenocarcinoma?

Adenoma - castration may be sufficient.
Carcinoma - combination of surgery, chemotherapy and radiotherapy

23

What is anal furunculosis?

Immune mediated attack of skin around the anus.

24

What is the treatment of choice for anal furunculosis?

High dose cyclosportin and then taper. Can also use topical creams but not as effective. Ketoconazole can prolong activity of cyclosporin but does have side effects.