Cecum Flashcards

1
Q

Cecal impaction

A

Type1: dry ingesta (constipation)
Type2: fluid, impaired cecal outflow, cecal rupture

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2
Q

What can cause a cecal impaction?

A

Anecdotal associations: chronic pain, poor dentition, ↓ water intake and poor quality roughage

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3
Q

Cecal rupture is associated with _________

A

Musculoskeletal pain

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4
Q

CS of cecal impaction

A

Masked by nonsteroidal anti-inflammatories
Reduced appetite
Low grade abdominal pain
Change in fecal quantity and quality

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5
Q

Type 1 impaction

A

Chronic condition (fair to good prog)
Mild to moderate intermittent pain
Gas and fluid can pass beyond mass
Pain more evident as cecum distends

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6
Q

Type 2 impaction

A

Progressive abdominal pain
HR elevates as cecum distends
Ping right paralumbar fossa
Endotoxemia
Guarded due to motility dysfunction

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7
Q

Dx Type 1 cecal impaction

A

Cecum in normal postion
Dry feed in base and body of cecum are full
Ventral band cecum evident
Signs unchanged for days

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8
Q

Dx of type 2 cecal impaction

A

Ingesta and fluid pull cecum forward
Worsening abdominal fluid

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9
Q

When is medical tx for cecal impaction needed?

A

If cecum is small or moderate size
Goal: empty cecum and return to normal motility

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10
Q

Medical tx for cecal impaction

A

Mineral oil, oral fluids, IV fluids
Flunixin meglumine
No feed, motility stimulators (erythromycin lactobionate, bethanechol, neostigme)- type 1

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11
Q

Post cecal impaction

A

Off feed 2-3d to allow cecum to empty
Additional 2 w: pelleted feed and small amounts of green grass

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12
Q

Sx indications for cecal impaction

A

No medical improvement for 3d
Extremely large cecum, recurrence of impaction, systemic deterioration, constant progressive abdominal pain

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13
Q

Sx for cecal impaction

A

Commone for type 2 impactions
Sudden rupture
Typhlotomy (type 1), ileo or jejunocolic anastomosis (type2), or cecocolic anastomosis

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14
Q

Ileocecal and cecocolic intussusceptions

A

Irritation or partial obstructions
Tapeworm infestations

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15
Q

Ileocecal intussusceptions

A

Acute to chronic colic
Acute signs: SI signs, false neg abdominocentesis
Chr.: SI distention and 2x normal size, nasogastric reflux

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16
Q

Cecocolic intussusceptions

A

Pain related to severity of lesion

17
Q

Reducible ileum tx

A

Correction of intussusception
Healthy ileum: ileocecal bypass
Unhealthy ileum: jejunocecostomy

18
Q

Non-reducible ileum tx

A

Small and chr: ileocecal bypass
Long and irreducible: reset within cecum, typhlotomy, exteriorize and resect ileum

19
Q

Reducible cecolic tx

A

Cecal resection
Ligation of lateral and medial vessels
2 double inverting layers
Stapling is difficult

20
Q

Nonreducible cecocolic tx

A

Reset cecum through r. ventral colon
Reduce intussusception
Reset balance of necrotic tissue

21
Q

Complications of Ileocecal and cecocolic intussusceptions

A

Difficult procedure
Avulsion of cecal vessels > hemorrhage
Necrosis of ileocecal orifice
Cecocolic orifice obstruction by ileocecal stump
Inoperative contamination

22
Q

Cecal infarction

A

Uncommon
Occurs in strangulating and non infacrtion, cecocecal or cecocolic intussusceptions

23
Q

Cecal infarction tx

A

Resection of diseased cecum
Ventral midline: cecal apex and body
Flank laparatomy: cecal base
Closure: double inverting or TA-90 stapling