Abdominal Trauma

Question 1

what is the correct initial approach?

Answer 1

• stabilise
• give fluids
• provide pain relief
• ex-lap (only if detect a deterioration or PCV<20% which is a sign of internal haemorrhage

Question 2

What is the correct way to do a clinical exam if expecting and abdominal trauma?

Answer 2

• inspection first
• superficial palpation
• deep palpation
• ballottement
• auscultation
• recatal

Question 3

What are the choices after clinical exam?

Answer 3

• abdominocentesis
• radiography
• US

Question 4

Abdominocentesis procedure

Answer 4

• 18g needle and syringe
• umnbilicus, at right of midline (to miss the spleen) and go about 2cm caudal (to avoid ligament and fat)
• look at grossly, do biochem and cytology

Question 5

Problems with the spleen

Answer 5

• often self repairs without detection of damage
• splenectomy is an option
• torsion can happen: on RHS on x ray rather than LHS

Question 6

Problems with the liver

• CS
• problems and their treatment

Answer 6

CS: pain, haemorrhage, shock

severe: euthanise
mild: lobectomy-blunt dissection at hilus, ligate and remove
fine tears: overlapping mattress sutures

Question 7

Problems with the bladder

Answer 7

-easily ruptured

Question 8

diagnosis and problems of a bladder problem

Answer 8

-measure urea, potassium and creatinine
(abdominal creatinine is higher than serum creatinine)
-may get a false positive if animal has just received a large volume of IVFT
-urination does not mean it is in tact

Question 9

Treatment if bladder rupture

Answer 9

trim and simple closure
can use omentum to block/seal
flush cavity

Question 10

Peritonitis

Answer 10

• diffuse inflammation
• due to bacterial contamination
• high mortality

Question 11

CS of peritonitis

Answer 11

anorexia
lethargy
vomiting
diarrhoea
pain
shock

Question 12

diagnosis of peritonitis

Answer 12

• CS
• Lab work (increase WBCs, dehydration, electrolyte abnormalities [low K and Na])
• x ray: loss of contrast (becomes fuzzy), clumping of bowel in one area, free air bubbles [usually over bladder/retroperitoneum])

Question 13

WBCs: normal vs abnormal

Answer 13

normal: 2kuL

(but after surgery this changes to

moderate: >7kuL
marked: >9kuL)

Question 14

Treatment of peritonitis

Answer 14

ABs:
aerobic bacteria:
-ampicillin (20mg/kg)
-enrofloxacillin (10mg/kg)

anaerobic bacteria:

• clindamycin (10mg/kg)
• metronidazole (10mg/kg

open peritoneal dreainage: hospitalise and close within 3-5days