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Small Animal Surgical Diseases > Abdominal Trauma and Hernias > Flashcards

Abdominal Trauma and Hernias Flashcards

1
Q

What are the various potential etiologies of abdominal trauma?

A
  1. motor vehicle accidents
  2. animal bites
  3. sharp and blunt trauma (gunshot, arrows, kicked by other animals)
  4. abuse
  5. unknown cause
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2
Q

when an animal presents with trauma, you need to ensure what is intact?

A

abdominal and thoracic internal organs as well as the body wall and diaphragm

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3
Q

What imaging modality can be used for quick assessment of air and/or fluid in the abdomen and/or thorax post-trauma?

A

FAST scan (focused assessment with sonography for trauma)

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4
Q

If there is fluid where fluid is not supposed to be, what 2 diagnostics can you use to determine the potential etiology of the fluid?

A

abdominocentesis
diagnostic peritoneal lavage

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5
Q

When air or fluid is in the abdomen, how do this appear on radiographs?

A

loss of abdominal detail
enhanced detail near diaphragm

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6
Q

T/F: free abdominal air is a surgical emergency

A

true

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7
Q

What tests (3) can you run on abdominal fluid samples?

A

PCV / TP
Biochemical tests (BUN, Lactate, Glucose, Creatinine, K)
Cytology

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8
Q

When testing abdominal fluid, you should always ensure you compare the results to blood levels in order to determine the significance.
What would you expect the lactate and glucose to be in the abdominal fluid compared to the blood?

A

Lactate would be HIGHER in the abdominal fluid than in the blood serum.
Glucose would be LOWER in the abdominal fluid than in the blood serum.

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9
Q

Why do we not use diagnostic peritoneal lavage commonly now?

A

its more invasive and requires sedation
we have FAST scans that can give us the same information much quicker.

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10
Q

A patient presents to your ER as a referral from the GP. This pt has abdominal pain, abdominal distention, and elevated liver enzymes. You collect bile from the abdomen via abdominocentesis. What is your plan?

A

This is not an emergency. Focus on stabilizing the patient. These can go undetected for 4-6 weeks.

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11
Q

A patient presents to your ER and you determine that it has uroabdomen. What is your plan?

A

Drain the urine and stabilize the patient by placing a urinary catheter to prevent additional build up FIRST.
THEN this patient will require surgical repair.

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12
Q

A patient presents to your ER and you determine it has hemoabdomen. What is your plan?

A

Stabilize the patient.
Consider the source of the blood.
Do conservative management in the mean time (keep pt calm, apply compression bandage, etc.)
This will likely be surgical repair, but focus on conservative management.

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13
Q

A patient presents to your ER and has septic abdominal fluid. What has occured and what is your plan?

A

Likely a ruptured hollow viscus.
Stabilize patient first
Then emergency surgery is indicated.

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14
Q

A patient presents unstable to your ER. On radiographs, you determine this patient has a diaphragmatic hernia. What is your plan?

A

stabilize this patient FIRST
then surgery to repair the hernia.

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15
Q

__________ is a protrusion of an organ through a defect in an anatomical cavity.

A

hernia

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16
Q

T/F: traumatic hernias are false hernias

A

true

17
Q

what is a TRUE hernia?

A

herniated contents are contained within an anatomical hernial sac.

18
Q

what is a FALSE hernia?

A

herniated contents LACK a hernial sac.

19
Q

how do we classify hernias?

A
  1. anatomical site
  2. reducible vs non-reducible
  3. incarcerated
  4. strangulated
  5. acquired vs congenital
20
Q

T/F: hernias usually occur at areas where the anatomy fails the easiest.

A

true

21
Q

what are the surgical goals of a herniorraphy?

A
  1. identify defect
  2. replace organs to normal location
  3. assess viability
  4. repair defect by securing ring closure and obliterating tissue in sac
  5. tension free closure
22
Q

how do you secure hernia ring closure?

A

direct approximation of local tissue and place sutures in structures that have holding power.

23
Q

T/F: most traumatic hernias are NOT emergencies

A

true. You can postpone surgery up to 3-5 days until the patient is stabilized. This will allow for declaration of devitalized tissues.

You should stabilize the patient first then work on completing your exam (bloodwork, imaging, thoracic and abdominal radiographs), assess for concurrent injuries, palpate the hernia and classify it.

24
Q

Most traumatic hernias are NOT emergencies. But, what are the exceptions to this?

A
  • penetrating wounds (bite, gunshot, stab)
  • incarcerated or strangulated hernias
  • other injury warranting sx intervention
  • severe hemorrhage
  • septic abdomen
  • pneumoperitoneum

Small Animal Surgical Diseases (20 decks)

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