Acute abdomen/GDV Flashcards
What are the common causes of an acute abdomen disorder?
Foreign body Gas gastroenteritis pancreatitis Gastric Dilation Vovulus haemoabdomen urinary tract obstruction pyometra
Rare causes of acute abdomen
Septic peitonitis
Mesenteric Volvulus
hepatic abscess
pyelonephrits
What major body sytems are affected by GDV?
shock hypovolameia respiratory depression decreased venous return distended abdomen weak pulses and weak pulse quality retching/unproductive of vomit pain on abdomen palpation
What tests should be considered in the GDV patient?
PCV/TS
haemotology
Biochem (renal values)
Clotting times
What analgesia should be considered for the GDV patient?
Opioids morphine methadone fentanyl do not give NSAIDS
What are the risk factors of GDV?
Breed body shape anxious temperament die-composition and number of meals speed of eating
What are the local effects of a GDV?
Gastric wall
spleen
What are the systemic effects of a GDV?
reduced venous return reduced cardiac output hypotension acidosis hyperlactaemia inflammatory mediators ischeamia re-perfusion injury SIRS Sepsis DIC
What is the initial approach to a GDV?
Stabilise fluids! oxygen decompress stomach establish GDV or GD Rapid surgical correction of vovulus prophylaxis (surgical/environmental)
How is the stomach decompressed in GDV?
Stomach tube
measure tube, pass the tube through vet wrap within the mouth, lavage with warm saline
percutaneous decompression
14-16g catheter placed at point of maximal distension
removes gas but not fluid
exlap soon after
Surgical management of a GDV
Gastric decompression and repositoning
gastropexy
Assessment of the viability of abdominal organs and resection of devitalised tissue
short period of aggressive stabilisation then surgery
Anaesthetic considerations GDV
limit the effects on the cardiorespiratory system opiates and diazepam propofol/alfaxalone isofulrane avoid nitrous IVFT antibiotics
What is increased lactate concentration associated with?
Tissue necrosis
How is gastric resection achieved?
Hand sewn
stapler
avoid invagination
What other condition may be seen in the GDV patient?
Splenic torsion
21%
How is gastropexy preformed?
incisional belt loop tube Avoid gastrocolonpexy laproscopic
How should you carry out post-operative care for GDV patient?
IVFT observe pulses, weak deficits Monitor temperature Gradually re-introduce to food Analgesia PCV/TS Urine output ECG/blood pressure
What are the complications associated with GDV?
cardiac arrythmias (VPCs, treat lidocaine) hypotension/hypoperfusion haemorrhage, inadequate IVFT, low COP) aspiration pneumonia monitor respiration and temp abnormal gastric motility Vomitting regurg metaclopromide infusion gastric protectants Gastric necrosis/ performation SIRS/sepsis/DIC
What is the outcome of a GDV?
Mortality 15% gastric necrosis and partial resection 30% Recurrence 70-80% Gastropexy 4-10%
Prophylactic gastropexy
risk/benefit
breeds disposed
laproscopic gastropexy
endoscopy
