Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Equine Medicine > Basics of SI Surgery Diseases > Flashcards

Basics of SI Surgery Diseases Flashcards

1
Q

DDx of Non-strangulating obstructions

A 
ileal impaction
muscular hypertrophy ileum
ascarid impaction
duo-prox jejunitis
gastroduo obstruction
intestinal inflamm and fibrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

DDx of Strangulating obstructions

A 
SI volvulus
EEF (epiploic)
Pedunc lipomas
intussusceptions
inguinal hernia
mesenteric rents
diaphragmatic hernia
incarceration of GP lig
vitelline anomalies
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

CLinical signs of a Strangulating obstruction

A 
acute and severe pain
no response to analgesics
acute/severe fever
high HR
mm congested
high PCV/TP, CRT, RR
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Small Intestinal Volvulus may develop because:

A 
(mesenteric axis rotation)
primary displacement
inguinal hernia
mesodiverticular band
meckel's diverticulum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Small Intestinal primary volvulus usually happens in and because

A

often foals 2-4 mo

a distinct spiral of intestine is made, entwined into a knot (nodosus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

C/S of Small Intestinal Volvulus

A 
severe, persistent pain
distention
increase HR
decreased motility
CV compromise (CRT, hemoconc)

Foals see lots of distention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Dx of Small Intestinal Volvulus

A 
Rectal exam looking for distended SI
US - wall edema, dist, fluid in intestines, hypomotile
Nasogastric tube (spont reflux of more than 2 L)
Abdominocentesis - changes in 1-2 hours of strangulation --> leaking protein and RBCs and WBCs (serousanguinous)

US is more accurate than rectal. !!!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How high is high for RBC, WBC, and protein on abnormal abdominocentesis

A

> 2.5 g/dL in protien
foals - >1500 cells/microL
adults - >10000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Tx of Small Intestinal Volvulus

A

Exploratory Celiotomy ventral midline
correct the volvulus
reserct the SI
anastomose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Prognosis of Small Intestinal Volvulus

A

High complication rate - more foals than adults

things like gastric reflux, abdominal pain, incisional infection, pyrexia, diarrhea, laminitis, and pneumonia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Lipomas found where

A

90% SI, 9% LI

14-19 yo horses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Who is at risk for lipomas?

A

ponies, arabians, QH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dx of Lipoma

A

Old horse
distended loops of SI on rectal
US - > 3cm diameter distention and hypomotile
Abdominocentesis depending on devitalization
nasgastric tube - spont reflux

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Clinical signs of Lipoma

A

same clinical signs as SI volvulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

DDx for spont gastric reflux >2L

A

proximal enteritis

the SI volvulus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Surgical treatment of Lipomas

A 
exploratory vnetral midline
sever the avascular pedicle
remove (blindly)
release trapped bowel
anastomosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Complications of Lipoma surgery

A

Post-op ileus

18
Q

Prog of Lipoma

A

favorable if done early.

poor once there is CV deterioration, intestinal necrosis and peritonitis

19
Q

risks of blindly removing the pedicle

A

risk creating a mesenteric rent

mesenteric bleeding

20
Q

classification of inguinal hernias

A

(counter-intuitive)
indirect - through vaginal tunic, so in scrotum
direct - rent near, but not through vaginal ring, so intestine lies in the SQ space

21
Q

Indirect hernias are/in and involve

A 
more common
short amount of intestine
Adult
aquired
non-reduceable
unilateral
22
Q

Acquired hernias are/in and involve

A 
more common in foals
longer lengths of intestine
adults - stallions
strenuous exercise
breeding
23
Q

What are some breed dispositions to Acquired hernias?

A

STB, Am Saddlebreds, tennessee walkers

24
Q

Process that predisposes to herniation (inguinal)

A

increased abdominal pressure –> enlarges the inguinal ring

25
Q

CLinical signs of an acqired inguinal hernia

A 
colds, swollen, firm testicles, 
moderate pain 
increased HR, CRT, TP/PCV
decreased motility
nasogastric reflux
26
Q

Pathogenesis of acquired inguinal hernia

A

hernia –> strangulation –> intestine compresses testicular vessels –> testicles go cold, firm, swollen

27
Q

CLinical signs of non-strangulating inguinal hernias

A

abnormally large vaginal and internal rings

swelling of inguinal area

28
Q

Dx of acquired inguinal hernias

A

palpation, rectal exam (important in males)

US - si distention, fluid in SI, si hypomotile

29
Q

Tx of reducible (direct) inguinal hernias

A

spont fixes after dorsal recumbency GA
per rectum gentle traction

But you can’t assess the viability of the bowel then

30
Q

Tx of non-reducible inguinal hernia

A

make inguinal incision along spermatic cord
go in by ventral midline and pull from there, after
assess bowel for viability
resect and anastomose
Unilateral castration, which allows
closure of the external inguinal ring

31
Q

Prognosis for acquired inguinal hernias

A

worse the longer, so refer early

reproductive soundness will still even be sound most likely

32
Q

EFE - Epliploic foramen entrapment borders what structures

A

CVC, portal vein
liver and pancreas
RDA

33
Q

EFE hits

A

all ages of horse

horses that crib

34
Q

EFE happens because

A

SI (Ileum) passes to the left side of the abdomen –> through the epiploic foramen

35
Q

Clinical signs of EFE

A 
not the same as typical entrapment
slight pain
gastric reflux
normal rectal
even these signs aren't always diagnostic
36
Q

Dx of EFE

A 
US - edematous SI wall > 3mm
distention over 3cm
see this in the ventral rt paralumbar fossa
caudal ventral abdomen 
and middle right paralumber fossa
37
Q

EFE REquire

A

Surgery

38
Q

how much of the SI can be resected?

A

up to 70%

39
Q

How to tell if the intstine is viable or not?

A

flick - if there is movement, feel pulses on vessels of mesentery, color, then good.

If non-viable, reperfusion injury

40
Q

What types of Jejunojejunostomy surgeries can be done for EFE?

A 
2 layer or 
single layer closure, 
stapled side to side
closed, stapled, one-stage end-to-end
stapled side-to-side
hand sewn end-to-side
41
Q

Post-op care for EFE

A 
fluids
AM
NSAIDs
take 2 days to start onto feed
hand-walking
out in 7-10 days
42
Q

What do we worry about post-operatively? what is the rule of 1s

A

1 - surgery
day 10 - adhesions and fibrosis maybe
day 100 - clinical signs from adhesions or jjostomy
1 year - just about out of the woods

Equine Medicine (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions