Surgical Approach to the Large Intestine Flashcards
What are the different approaches that can be taken to access the LI?
Ventral Midline Laparotomy
Pelvic Split
Transanal
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?
PDS II
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 Wound infeciton Abscess formation Faecal incontinence Stricture & Tenesmus Rectal prolapse Heamatochezia
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 Medical: -Enemas -Prokinetics -Laxatives -High Fibre, low residue diet -Increase walks 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?
weight loss tenesmus heamatochezia increased defecation frequency rectal prolapse ribbon like faeces
How could neoplasia of the LI be diagnosed?
Rectal exam (60-80%)
Radiography
Ultrasound
Colonoscopy
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?
Parasites
Rectal neoplasia
Perineal hernias
