Cecum Flashcards
Cecal impaction
Type1: dry ingesta (constipation)
Type2: fluid, impaired cecal outflow, cecal rupture
What can cause a cecal impaction?
Anecdotal associations: chronic pain, poor dentition, ↓ water intake and poor quality roughage
Cecal rupture is associated with _________
Musculoskeletal pain
CS of cecal impaction
Masked by nonsteroidal anti-inflammatories
Reduced appetite
Low grade abdominal pain
Change in fecal quantity and quality
Type 1 impaction
Chronic condition (fair to good prog)
Mild to moderate intermittent pain
Gas and fluid can pass beyond mass
Pain more evident as cecum distends
Type 2 impaction
Progressive abdominal pain
HR elevates as cecum distends
Ping right paralumbar fossa
Endotoxemia
Guarded due to motility dysfunction
Dx Type 1 cecal impaction
Cecum in normal postion
Dry feed in base and body of cecum are full
Ventral band cecum evident
Signs unchanged for days
Dx of type 2 cecal impaction
Ingesta and fluid pull cecum forward
Worsening abdominal fluid
When is medical tx for cecal impaction needed?
If cecum is small or moderate size
Goal: empty cecum and return to normal motility
Medical tx for cecal impaction
Mineral oil, oral fluids, IV fluids
Flunixin meglumine
No feed, motility stimulators (erythromycin lactobionate, bethanechol, neostigme)- type 1
Post cecal impaction
Off feed 2-3d to allow cecum to empty
Additional 2 w: pelleted feed and small amounts of green grass
Sx indications for cecal impaction
No medical improvement for 3d
Extremely large cecum, recurrence of impaction, systemic deterioration, constant progressive abdominal pain
Sx for cecal impaction
Commone for type 2 impactions
Sudden rupture
Typhlotomy (type 1), ileo or jejunocolic anastomosis (type2), or cecocolic anastomosis
Ileocecal and cecocolic intussusceptions
Irritation or partial obstructions
Tapeworm infestations
Ileocecal intussusceptions
Acute to chronic colic
Acute signs: SI signs, false neg abdominocentesis
Chr.: SI distention and 2x normal size, nasogastric reflux
Cecocolic intussusceptions
Pain related to severity of lesion
Reducible ileum tx
Correction of intussusception
Healthy ileum: ileocecal bypass
Unhealthy ileum: jejunocecostomy
Non-reducible ileum tx
Small and chr: ileocecal bypass
Long and irreducible: reset within cecum, typhlotomy, exteriorize and resect ileum
Reducible cecolic tx
Cecal resection
Ligation of lateral and medial vessels
2 double inverting layers
Stapling is difficult
Nonreducible cecocolic tx
Reset cecum through r. ventral colon
Reduce intussusception
Reset balance of necrotic tissue
Complications of Ileocecal and cecocolic intussusceptions
Difficult procedure
Avulsion of cecal vessels > hemorrhage
Necrosis of ileocecal orifice
Cecocolic orifice obstruction by ileocecal stump
Inoperative contamination
Cecal infarction
Uncommon
Occurs in strangulating and non infacrtion, cecocecal or cecocolic intussusceptions
Cecal infarction tx
Resection of diseased cecum
Ventral midline: cecal apex and body
Flank laparatomy: cecal base
Closure: double inverting or TA-90 stapling
