Bovine Esophageal, Rumenotoy, Pericarditis Flashcards
Clinical Signs of Esophageal Choke:
1. 2. 3. 4. 5.
- Bloat
- Salivation
- Coughing/retching
- Extended head and neck
- Protruding tongue
Two main DDx for Esophageal Choke?
Pharyngeal trauma, RABIES
3 Main complications of Esophageal Choke:
1.
2.
3.
- Unable to eructate = bloat
- Loss of saliva = metabolic acidosis
- Aspiration pneumonia
Esophageal Choke: Tx:
Medical:
1. ___ retrevial.
- Use ___ to retrieve
- Push….
4.
- manual (if proximal esophagus)
- wire snare
- into rumen with stomach tube
Main surgery to treat esophageal choke?
When should you consider it?
Esophagotomy
If medical tx options have all been exhausted, because it is a sx with many complications
2 main things you should be doing during initial treatment of choke?
Decompress rumen and hold off feed and water
Layers of the esopagus:
1.
2.
3.
4.
- Adventitial layer
- Muscular layer
- Submucosa
- Mucosa
Structures that are anatomically closely associated with the esophagus in Bovines:
1. 2. 3. 4. 5.
- recurrent laryngeal nerve
- Carotid sheath
- Vagosympathetic trunk
- Tracheal lymphatic trunk
- Deep cervical lymph node
Esophageal Surgery is an (simple/complex) sx. Why?
Complex.
no serosal layer, constant movement, proximity of laryngeal n, required constant suture line technique, it’s dirty.
Describe the steps of a cervical esophagotomy up to removal of FB
Pass tube to obstruction,
exteriorize and isolate affected region of esophagus
Linear incision into esophagus over healthy tissue (if possible)
Remove FB
Closure of cervical esophagotomy:
If healthy tissue?
If compromised tissue?
May need to place…..
Close normally
Leave to heal by 2nd intention
rumen fistula
Cervical esophagotomy with 1° Repair:
Performed with animal in what position?
standing sedation
Cervical esophagotomy with 1° Repair:
Surgical approach?
Lateral/ventrolateral
Cervical esophagotomy with 1° Repair:
Upon incision, seperates into how many layers? What are those layers?
2 layers, the muscular layer and mucosa/submucosal layer
Cervical esophagotomy with 1° Repair:
Closure technique?
PDS to close, bury knots in lumen. Use mucosa/submucosa for tensile strength
Cervical esophagotomy with 1° Repair:
Post-op complications common d/t…
Lack of serosal layer
Cervical esophagotomy with 1° Repair:
Ventral aproach to do what two things:
1
2
- Blunt dissection of left side of trachea to ID esophagus
2. Retract trachea to the right.
Cervical esophagotomy with 1° Repair:
Ventrolateral approach is used for……
feeding tube placement
Cervical esophagotomy with 1° Repair:
Incision site?
ventral to jugular v
Cervical esophagotomy with 1° Repair:
Seperate what two muscles at incision site?
Sternocephalicus and brachiocephalicus
Cervical esophagotomy with 1° Repair:
Where do you incise esophagus?
over or caudal to FB
Cervical esophagotomy with 1° Repair:
Closure technique?
Close mucosa/submucosa with knots buried in lumen. Than close muscular layer
Cervical esophagotomy with 1° Repair:
Post-op care?
Active drain for 48 hours
No food for 48 hours.
Abx
IV fluids w/electrolytes
Esophagostomy
Performed when?
If tissue is compromised
Esophagostomy
performed (cranial/caudal) to repaired esophagus?
Caudal to
Esophagostomy
Tube you place inside?
Polyethylene NG tube
Esophagostomy
Leave polyethylene tube in place for how long? What is the goal of leaving it in there that long?
7-10 days to allow stroma formation
Esophagostomy
Closure method?
Heal by second intention
Temporary Rumen Fistula:
Function?
Immediate relief of chronic bloat
2 benefits of Temporary Rumen Fistula:
1
2
- Direct feeding into rumen
2. Reversible
Temporary Rumen Fistula:
Location?
Upper left paralumbar fossa
Temporary Rumen Fistula:
(do/do not) use sharp dissection
Do not.
Temporary Rumen Fistula:
Placement technique:
Grasp and tent rumen wall
Suture rumen to skin in mattress pattern.
Incise with 1 inch of rumen sticking out of skin
Secure 35 mL syring casing
Rumenotomy:
Indications:
1.
2.
3.
4.
- Chronic bloat
- Foreign body
- Reticular abscess
- Type II vagal indigestion
Type II vagal distension:
Due to failure of.
omasal transport
Type II vagal indigestion:
results in….
distension of reticulum/rumen
Rumenotomy:
Off feed how long beforehand?
24-36 hours
Rumenotomy:
Approach?
Left flank.
Rumenotomy:
T/F: considered a “dirty” procedure
F, a clean-contaminated procedure
Rumenotomy:
Suture pattern? What are you suturing together? Start from (ventral/dorsal) aspect?
Cushing to suture rumen to skin. dorsal.
Rumenotomy:
Describe a rumen board set-up.
Non-crushing rumen forceps hooked across a board.
Rumenotomy:
What is the benefit of a rumen board?
Allows exteriorization of the rumen.
Rumenotomy:
Closure method?
2 layer inverting closure, being sure to lavage the site.
Rumenotomy:
What should you do after completing closure of the 2 layer inverting pattern?
Change gloves/sleeves/instruments prior to body wall closure
During Rumenotomy, what is the function of Kingman tube?
siphon fluid from the rumen
Rumenotomy:
Prognosis dependent on _____
Reason for procedure.
Prognosis of Rumenotomy to remove FB is good if…
if FB doesnt penetrate thoracic cavity OR involve right side of reticulum
Prognosis of Rumenotomy to remove FB is guarded if…
involvement of right side of reticulum
Prognosis of Rumenotomy to remove FB is poor if…
FB penetrated diaphragm
Clinical signs of Traumatic reticulopreicarditis 1 a) b) c)
2.
3.
- CxS of right sided heart failure
a) Distended jugular v
b) brisket edema
c) tachypnea - Tachycardia with muffled heart sounds
- CxS of GI disease a week prior
Clinical signs of right-sided heart failure that you will see in a traumatic reticulopericarditis case?
1
2
3
- Distended jugular v
- Brisket edema
- Tachypnea
Three ways to diagnose traumatic reticulopericarditis
1
2
3
- rads
- U/s
- Pericardiocentesis
3 treatment options for Traumatic Pericarditis
1.
2.
3.
4.
- Salvage
- Antibiotics
- Pericardial lavage
- Pericardectomy
