Surgical Diseases of the Rectum and Anus Flashcards Preview

RUSVM Large Animal Surgery > Surgical Diseases of the Rectum and Anus > Flashcards

Flashcards in Surgical Diseases of the Rectum and Anus Deck (27):
1

This is a Grade ___ rectal prolapse

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Grade 4

  • Image shows a Grade 4 rectal prolapse with a tear and omentum
  • Requires a celiotomy and maybe amputation of the infarcted portion of the small colon and rectum

2

What surgery is being performed here?

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rectal amputation

  • Needles placed in the viable rectum for stabilization
  • Place ligating sutures full thickness through the rectum
  • Amputate distal to the suture

3

When is a colostomy recommended for rectal tears?

Tears >25% of rectal diameter or tears located >50cm inside rectum

  • Colostomy is fecal diversion to the left paralumbar fossa
    • ​Colostomy will result in complete diversion of the feces and can be maintained as long as necessary for the rectal tear to heal

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4

T/F: All four grades of rectal prolapse have exposed mucosa

True

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5

A tear that penetrates into the peritoneal cavity describes a Grade ____ rectal tear

Grade IV

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6

What can be done to create inflammation and adhesions around the rectum in ruminants?

Inject iodine perirectally

Using your finger (or Kanye's finger) and a 1.5" needle. This technique can NOT be used in foals or mares! They are too sensitive and would probably cry.

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7

What are some causes of rectal prolapse in large animals?

constipation, impaction, dystocia, intestinal parasitism, colitis, urethral obstruction, excessive coughing, diarrhea, short tail

8

What is your diagnosis? 

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rectal prolapse and vaginal prolapse

The rectum is devitalized and needs to be removed. The two options for thise are submucosal resection of the rectum or complete amputation (more commonly performed)

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9

What is your diagnosis?

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Grade IV rectal tear

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10

What is your diagnosis?

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Grade III rectal tear

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11

This is a Grade ____ rectal prolapse in a sheep

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Grade 2

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12

What is your diagnosis? 

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rectal prolapse and vaginal prolapse

Treatment: surgical resection of devitalized tissue

13

A tear through the muscularis layer describes a Grade ____ rectal tear

Grade II

(Mucosa and serosa still intact)

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14

How is a rectal liner removed?

Chromic gut is used to suture it in place. This breaks down in 2 weeks and the PVC pipe and plastic bag are passed in feces

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15

A tear through the mucosa, submucosa, and muscularis describes a Grade ____ rectal tear

Grade III

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16

Prognosis for rectal tears depends on the grade of the tear. Grades 1 and 2 are good (82%). Grades 3 and 4 are fair to poor.

  • Survival rate with colostomy is ~_____
  • Survival rate with rectal liner is ~_____

  • Survival rate with colostomy is ~60%
  • Survival rate with rectal liner is ~40%

17

What is the treatment for Grade I or II rectal tears?

  • Antibiotics
  • Analgesics
  • Laxatives/Diet to cause soft feces
  • NO RECTAL PALPATION!

18

What is the treatment for rectal prolapse?

  • Epidural anesthesia
  • Manual reduction (or surgery if tissue is devitalized or manual reduction is impossible)
  • Topical agents to decrease edema
  • +/- purse string suture

19

What surgical approach is needed to place a rectal liner?

Caudal ventral midline incision​

Rectal liner is constructed by gluing a palpation sleeve with the hand removed to a 5cm diameter and 7cm long rectal prolapse ring. The rectal liner is positioned cranial to the tear

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20

What is your diagnosis?

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Grade I rectal tear

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21

Why should the patient be kept standing until the rectal liner has been passed?

To prevent retraction of the liner into the rectum when the horse lies down

22

A tear through the mucosa and/or submucosa describes a Grade ____ rectal tear

Grade I

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23

What is the main cause of rectal tears in equine patients?

Iatrogenic (rectal palpation)

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24

Which grade(s) of rectal tear should be referred?

Grades ​3 and 4

25

What is the difference between a Grade IIIa and IIIb rectal tear?

  • 3a: serosa remains intact
  • 3b: extension into the mesocolon

26

T/F: Type 1 and 2 rectal prolapse will rarely cause complete obstruction

True

Type 1 and 2 prolapse will rarely cause complete obstruction unless they are present for a long time

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27

What is your diagnosis?

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Grade II rectal tear

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