Chapter 35 - Jej and ileum surgical tx Flashcards
In chronic intussusception of the ileum, what is the typical length of the affected segment?
A) 5 cm
B) 10 cm
C) 15 cm
D) 20 cm
B) 10 cm
In ileoileal intussusception, how many cases out of 16 were reported to have been impossible to reduce?
A) 7
B) 10
C) 11
D) 12
C) 11
Which surgical method is recommended when permanent ileal changes and the risk of recurrence are concerns?
A) Resection
B) Ileocecostomy bypass
C) Stapled jejunoileostomy
D) Jejunal transection
B) Ileocecostomy bypass
What technique is recommended over stapling instruments due to the thickness of the ileal wall?
A) Laparoscopic stapling
B) Hand-sewn technique
C) Intestinal grafting
D) Circular stapler
B) Hand-sewn technique
What are the potential long-term complications of ileocecostomy for chronic ileocecal intussusception?
A) Jejunal torsion
B) Stomal impaction, ileal hypertrophy, and rupture distal to the stoma
C) Cecal volvulus
D) Adhesion formation and intestinal necrosis
B) Stomal impaction, ileal hypertrophy, and rupture distal to the stoma
In cases where the intussusception cannot be reduced, what is the preferred treatment option?
A) Reduction with myotomy
B) Full resection
C) Intestinal bypass
D) Ligation of the mesenteric vessels
B) Full resection
What is a common postoperative complication of jejunocecostomy without reduction?
A) Hemorrhage from the intussusceptum
B) Intestinal stricture
C) Infection at the stoma site
D) Recurrence of intussusception
A) Hemorrhage from the intussusceptum
What can be used to reduce contamination during a typhlotomy?
A) Laparoscopic suction
B) Suturing an impermeable plastic drape
C) Saline lavage
D) Antibiotic irrigation
B) Suturing an impermeable plastic drape
When performing surgery on an intussusception, what is the risk of transecting the jejunum too far from the ileocecal junction?
A) Bowel perforation
B) Mesenteric vessel tearing and fatal hemorrhage
C) Formation of adhesions
D) Lack of proper anastomosis
B) Mesenteric vessel tearing and fatal hemorrhage
Which surgical stapler is commonly used to remove necrotic bowel tissue in the ileum during intussusception surgery?
A) GIA (Gastrointestinal Anastomosis) stapler
B) Circular stapler
C) TA-90 stapler
D) Linear cutter stapler
C) TA-90 stapler
In jejunojejunal intussusception, what shape is formed by the intussusceptum due to tension on the mesentery?
A) Coil-like
B) Corkscrew configuration
C) S-shaped
D) Spiral configuration
B) Corkscrew configuration
What is the best method for reducing a jejunojejunal intussusception?
A) Forceful traction on the intussusceptum
B) Gentle massage and slow traction on the intussusceptum
C) Myotomy and traction
D) Surgical resection only
B) Gentle massage and slow traction on the intussusceptum
What is a potential complication during the reduction of an intussusception?
A) Obstruction of the cecum
B) Tearing of the bowel wall and mesenteric vessels
C) Ischemia of the small intestine
D) Perforation of the large colon
B) Tearing of the bowel wall and mesenteric vessels
What is the prognosis for horses undergoing surgery for intussusceptions?
A) Poor due to high recurrence
B) Favorable for all intussusceptions
C) Guarded due to infection risk
D) Variable depending on the segment involved
B) Favorable for all intussusceptions
Which treatment is recommended for horses and pasturemates if Anoplocephala perfoliata is involved in ileocecal intussusception?
A) Fenbendazole
B) Pyrantel pamoate and praziquantel
C) Metronidazole
D) Ivermectin
B) Pyrantel pamoate and praziquantel
Why are fecal egg counts using the McMaster method unreliable in the diagnosis of Anoplocephala perfoliata?
A) Eggs are shed inconsistently
B) Fecal sample size is too small
C) Eggs are too large to be detected
D) The parasite is not fecally transmitted
A) Eggs are shed inconsistently
What alternative diagnostic method can be used to detect Anoplocephala perfoliata in horses?
A) Radiography
B) Saliva-based or serologic ELISA test
C) Endoscopy
D) Ultrasonography
B) Saliva-based or serologic ELISA test
During a typhlotomy, what risk does the removal of the intussusceptum carry?
A) Intestinal perforation
B) Severe contamination
C) Formation of a hernia
D) Adhesion formation
B) Severe contamination
What surgical complication can occur if too much bowel is drawn through the incision during intussusception surgery?
A) Bowel torsion
B) Mesenteric vessel tearing
C) Formation of a fistula
D) Adhesion development
B) Mesenteric vessel tearing
What percentage of short-term survival was reported for acute mesenteric tears in one study?
A) 60%
B) 47%
C) 72%
D) 85%
B) 47%
Chronic mesenteric tears are most commonly reported in which type of horses?
A) Stallions
B) Geldings
C) Multiparous mares
D) Young foals
C) Multiparous mares
Which segment of the intestine is most often involved in mesenteric rents?
A) Ileum
B) Jejunum
C) Duodenum
D) Colon
B) Jejunum
Mesenteric rents could be congenital or develop after which event?
A) Colic surgery
B) Small intestinal surgery
C) Castration
D) Foaling
B) Small intestinal surgery
In which part of the mesentery do chronic rents typically develop?
A) Ileal mesentery
B) Duodenojejunal mesentery
C) Cecal mesentery
D) Colonic mesentery
B) Duodenojejunal mesentery
In postparturient mares, mesenteric rents can cause which complication?
A) Strangulation of a more distant portion of the small intestine
B) Volvulus
C) Diarrhea
D) Dehydration
A) Strangulation of a more distant portion of the small intestine
Strangulation in chronic tears of the duodenojejunal mesentery has what prognosis for survival?
A) Poor
B) Moderate
C) Excellent
D) Unpredictable
C) Excellent
What is the recommended procedure for mesenteric tears to reduce the risk of postoperative colic?
A) Leave the tear open
B) Perform a laparoscopic closure
C) Perform an intestinal resection
D) Complete repair of the tear through a ventral midline approach
B) Perform a laparoscopic closure
Nonstrangulating infarction of the left ventral colon.
Colonic mucosa of a horse with heavy cyathostomin
infection. Each black spot in the mucosa is an encysted
cyathostomin parasite.
Mucosal surface of the cecum with massive edema and anophlocephala perfoliata
Ascarid worms in the small intestinal lumen of a
young horse.
Which intestinal segment is typically involved in entrapment by the gastrosplenic ligament (ESIGL)?
A) Duodenum
B) Ileum
C) Cecum
D) Jejunum
D) Jejunum
What percentage of exploratory celiotomies are due to ESIGL according to some studies?
A) 1%-3%
B) 5%-9%
C) 4.6%-10.7%
D) 11%-15%
C) 4.6%-10.7%
Which horses are more prone to developing ESIGL?
A) Mares
B) Stallions
C) Geldings
D) Foals
C) Geldings
Which artery supplies blood to the gastrosplenic ligament?
A) Hepatic artery
B) Gastroepiploic artery
C) Mesenteric artery
D) Phrenic artery
B) Gastroepiploic artery
In cases of ESIGL, where is the small intestine often found preoperatively on ultrasonography?
A) Between the spleen and liver
B) Between the spleen and left body wall
C) Between the cecum and right body wall
D) Between the stomach and right body wall
B) Between the spleen and left body wall
The major indication for surgery in ESIGL cases is based on which finding?
A) Fecal impaction
B) Colic caused by a strangulating small intestinal lesion
C) Hemorrhage from the intestine
D) Intestinal rupture
B) Colic caused by a strangulating small intestinal lesion
In some ESIGL surgeries, what is required to release the strangulated intestine?
A) Manual reduction
B) Transection of the ligament
C) Gastrostomy
D) Resection of the intestine
B) Transection of the ligament
A mesodiverticular band is a remnant of what embryonic structure?
A) Allantois
B) Vitelline artery and associated mesentery
C) Urachus
D) Omphalomesenteric duct
B) Vitelline artery and associated mesentery
Mesodiverticular bands are typically found in which part of the intestine?
A) Distal jejunum
B) Proximal duodenum
C) Colon
D) Ileum
A) Distal jejunum
A Meckel diverticulum is a remnant of which duct?
A) Omphalomesenteric duct
B) Allantoic duct
C) Bile duct
D) Pharyngeal duct
A) Omphalomesenteric duct
Where is a Meckel diverticulum typically located in the horse?
A) 20 cm from the cecum
B) 40-120 cm from the ileocecal junction
C) At the duodenojejunal flexure
D) 50-100 cm from the stomach
B) 40-120 cm from the ileocecal junction
What is a possible consequence of a Meckel diverticulum becoming impacted?
A) Intestinal perforation
B) Bowel resection
C) Diarrhea
D) Intestinal torsion
A) Intestinal perforation
A fibrous band from Meckel diverticulum to the umbilicus is called what?
A) Mesodiverticular band
B) Vitelloumbilical band
C) Gastrosplenic ligament
D) Urachal ligament
B) Vitelloumbilical band
What can result if the vitelloumbilical band persists in adult horses?
A) Strangulation of the small intestine
B) Volvulus of the colon
C) Intestinal perforation
D) Duodenal obstruction
A) Strangulation of the small intestine
Meckel diverticulum has been implicated in causing which condition in horses?
A) Intestinal volvulus nodosus
B) Colitis
C) Gastric ulcers
D) Intestinal neoplasia
A) Intestinal volvulus nodosus
What is a possible finding during surgery for chronic duodenojejunal mesenteric tears in broodmares?
A) Acute hemorrhage
B) Fibrotic edges of the tear
C) Complete obstruction of the intestine
D) Abscess formation
B) Fibrotic edges of the tear
Mesenteric rents are most common in which period for broodmares?
A) Early gestation
B) Postpartum
C) Mid-gestation
D) During foaling
B) Postpartum
Closure of mesenteric rents is difficult in which horses?
A) Pregnant mares
B) Young stallions
C) Geldings with colic history
D) Foals
A) Pregnant mares
What is the likelihood of mares affected by chronic mesenteric tears having successful foalings after surgery?
A) Low
B) Moderate
C) High
D) Uncertain
C) High
Douglas et al 2021 the outcomes of pregnant broodmares treated for colic at a tertiary care facility are to survie to discharge alive are:
A) 70%
2) 48%
3) 36%
4) 82%
A) 70%
In Douglas et al 2021 the outcomes of pregnant broodmares treated for colic at a tertiary care facility the 2 factors that were associated with reduced survival are:
A) high lactate, high PCV
B) high lactate, low PCV
C) high PCV
D) high lactate
A) high lactate, high PCV
In Douglas et al 2021 the outcomes of pregnant broodmares treated for colic at a tertiary care facility the 2 factors what was the % of mares with recurrent colic?
A) 47%
2) 52%
3) 66%
4) 77%
A) 47%
Which of the following could result from failure to close a mesenteric rent?
A) Increased risk of postoperative infection
B) Reentrapment and repeat colic episodes
C) Rapid recovery without complications
D) Reduced blood flow to the intestine
B) Reentrapment and repeat colic episodes
Which gender of horses is more prone to developing mesenteric rents?
A) Stallions
B) Mares
C) Geldings
D) Foals
B) Mares
In what percentage of cases was Meckel diverticulum found responsible for death at necropsy in one study?
A) 0.01%
B) 0.03%
C) 0.1%
D) 0.5%
B) 0.03%
What is one possible outcome of a vitelloumbilical band in horses?
A) Diarrhea
B) Intestinal volvulus
C) Inguinal hernia
D) Rectal prolapse
B) Intestinal volvulus
Entrapment in the gastrosplenic ligament typically involves which direction of the intestine?
A) Left to right
B) Craniad to caudad
C) Right to left
D) Medial to lateral
C) Right to left
The celiac artery branches into which artery to supply the gastrosplenic ligament?
A) Gastroepiploic artery
B) Hepatic artery
C) Phrenic artery
D) Renal artery
A) Gastroepiploic artery
What type of ultrasonographic findings support a diagnosis of ESIGL?
A) Thickened small intestine loops between spleen and left body wall
B) Free abdominal fluid
C) Enlarged cecum
D) Stomach displacement
A) Thickened small intestine loops between spleen and left body wall
Meckel diverticulum can lead to which serious complication?
A) Colonic torsion
B) Peritonitis
C) Diarrhea
D) Hemorrhage
B) Peritonitis
Mesenteric rents that extend to the root of the mesentery may be difficult to close through which surgical approach?
A) Laparoscopic approach
B) Thoracic approach
C) Ventral midline approach
D) Flank approach
C) Ventral midline approach
What is a Richter hernia?
A) Incarceration of the entire bowel wall
B) Incarceration of only a portion of the antimesenteric wall
C) Incarceration of the mesentery only
D) Herniation of the diaphragm
B) Incarceration of only a portion of the antimesenteric wall
Which of the following may suggest a parietal hernia?
A) Reducible hernia
B) Non-reducible, firm, edematous, and painful umbilical hernia
C) Hernia with respiratory distress
D) Painless hernia
B) Non-reducible, firm, edematous, and painful umbilical hernia
What can a parietal hernia lead to?
A) Colonic torsion
B) Enterocutaneous fistula formation
C) Pulmonary abscess
D) Pleural effusion
B) Enterocutaneous fistula formation
Surgical correction of umbilical lesions involves a celiotomy of what size?
A) 5-10 cm
B) 10-15 cm
C) 15-20 cm
D) 20-25 cm
B) 10-15 cm
Which type of hernia is most commonly seen in foals within the first few days of life?
A) Richter hernia
B) Diaphragmatic hernia
C) Umbilical hernia
D) Femoral hernia
B) Diaphragmatic hernia
Diaphragmatic hernias in foals can result from which of the following?
A) Abnormal rib fracture at birth
B) Herniation of the liver
C) Uterine rupture
D) Umbilical torsion
A) Abnormal rib fracture at birth
What is the most common cause of diaphragmatic hernia in adult horses?
A) Overfeeding
B) Trauma
C) Dehydration
D) Parasite infection
B) Trauma
Which organs most commonly enter a diaphragmatic defect?
A) Stomach and spleen
B) Small intestine
C) Liver and kidney
D) Cecum and colon
B) Small intestine
Small diaphragmatic defects are more likely to cause what symptom in horses?
A) Dyspnea
B) Severe colic
C) Diarrhea
D) Fever
B) Severe colic
What diagnostic tool is considered superior for small diaphragmatic tears in horses?
A) Radiography
B) Ultrasonography
C) Endoscopy
D) MRI
B) Ultrasonography
What is an advantage of preoperative diagnosis of diaphragmatic hernia?
A) Shorter surgery time
B) Prevents recurrence
C) Allows better placement of the abdominal incision
D) Less postoperative care
C) Allows better placement of the abdominal incision
What is often required for a diaphragmatic defect that cannot be sutured due to its large size?
A) Mesh coverage
B) Suture with absorbable material
C) Partial closure
D) Endoscopic repair
A) Mesh coverage
Inaccessible diaphragmatic defects in standing horses can be repaired through which surgical technique?
A) Laparoscopy
B) Thoracoscopy
C) Laparotomy
D) Endoscopy
B) Thoracoscopy
What is used to correct pneumothorax postoperatively in horses with diaphragmatic hernias?
A) Pleural lavage
B) Heimlich valve
C) Chest compression
D) Oxygen therapy
B) Heimlich valve
in which scenario can a horse return to full athletic function without closure of a diaphragmatic defect?
A) When the defect is small
B) When the defect is congenital
C) When adhesions prevent closure
D) When the hernia is repaired via thoracotomy
A) When the defect is small
What can lead to a recurrence of intestinal incarceration after surgery for a diaphragmatic hernia?
A) Use of absorbable sutures
B) Releasing tension on the suture line
C) Incomplete closure of the defect
D) Mesh reinforcement
C) Incomplete closure of the defect
What surgical complication may require blind ligation of mesenteric bands?
A) Uterine torsion
B) Small intestinal strangulation
C) Femoral hernia
D) Mesenteric hematoma
B) Small intestinal strangulation
Strangulated bowel is removed along with how much healthy intestine?
A) 10 cm
B) 30 cm
C) 50 cm
D) 100 cm
C) 50 cm
What prevents rotation or entrapment of bowel after mesenteric resection?
A) Mesh reinforcement
B) Careful suturing of the mesentery
C) Large mesenteric openings
D) Suturing with nonabsorbable material
B) Careful suturing of the mesentery
Which ligamentous structure can cause small intestine strangulation?
A) Gastrosplenic ligament
B) Cecocolic fold
C) Lateral ligament of the urinary bladder
D) Mesoductus deferens
B) Cecocolic fold
Mesenteric hematomas are known to cause which complication?
A) Dyspnea
B) Intestinal necrosis
C) Hemorrhage
D) Liver rupture
B) Intestinal necrosis
Which postoperative complication can lead to a volvulus due to adhesions?
A) Pulmonary edema
B) Postoperative reflux
C) Recurrent colic
D) Nonstrangulating infarction
C) Recurrent colic
Resection of strangulated bowel is often done after what surgical procedure?
A) Complete mesenteric resection
B) Intestinal decompression
C) Thoracic incision
D) Peritoneal lavage
A) complete mesenteric resection
Which artery must be left intact during small intestinal anastomosis?
A) Inferior mesenteric artery
B) Superior mesenteric artery
C) Arcuate artery
D) Renal artery
C) Arcuate artery
Which structure may prevent laparoscopic access to a diaphragmatic defect?
A) Liver
B) Kidney
C) Spleen
D) Stomach
C) Spleen
What surgical tool can be used to enlarge small diaphragmatic defects for bowel release?
A) Scalpel
B) Curved fetotome
C) Hemostat
D) Ultrasonic scalpel
B) Curved fetotome
How is tension reduced during mesenteric resection?
A) By tying sutures before decompression
B) By ensuring even spacing of sutures
C) By waiting until after decompression to tie sutures
D) By using non-absorbable sutures
C) By waiting until after decompression to tie sutures
Adhesions after small intestinal surgery may lead to what?
A) Formation of fibrous bands
B) Immediate healing
C) Incomplete closure
D) Reduced risk of volvulus
A) Formation of fibrous bands
What type of suture pattern is used to close diaphragmatic defects?
A) Interrupted pattern
B) Continuous pattern
C) Mattress suture
D) Horizontal suture
B) Continuous pattern
What material may be used for mesh repair in diaphragmatic defects?
A) Polypropylene mesh
B) Silicone mesh
C) Polyethylene mesh
D) Gore-Tex mesh
A) Polypropylene mesh
What is a primary concern when decompressing the bowel post-surgery?
A) Rupture of the mesentery
B) Overhydration of the bowel
C) Loss of vascular supply
D) Tension on the mesenteric suture line
D) Tension on the mesenteric suture line
What vessel is ligated to control hemorrhage during mesenteric resection?
A) Major mesenteric artery
B) Minor mesenteric artery
C) Arcuate artery
D) Renal artery
A) Major mesenteric artery
Which surgical approach is best for ventral diaphragmatic defects?
A) Thoracoscopy
B) Paracostal incision
C) Ventral midline approach
D) Rib resection
C) Ventral midline approach
Which structure may cause intestinal strangulation in the nephrosplenic space?
A) Spleen
B) Liver
C) Kidney
D) Bladder
A) Spleen
Which condition may allow a horse to return to competition after diaphragmatic repair?
A) Small unrepaired diaphragmatic defect
B) Large unrepaired defect
C) Diaphragmatic tear
D) Adhesion of the stomach to the diaphragm
A) Small unrepaired diaphragmatic defect
Eventration through which structure can cause small intestinal strangulation?
A) Vaginal fornix
B) Diaphragmatic defect
C) Umbilical ring
D) Femoral canal
A) Vaginal fornix
Nonstrangulating infarction in horses is known to affect which structure?
A) Cecum
B) Colon
C) Small intestine
D) Stomach
C) Small intestine
What is the recommended proximal distance for Penrose drain ligature placement to prevent leakage during jejunojejunostomy?
A) 50-70 cm
B) 70-100 cm
C) 30-50 cm
D) 10-20 cm
B) 70-100 cm
Why are Penrose drains preferred over Doyen clamps during jejunojejunostomy?
A) Easier to use
B) Less traumatic
C) More effective at preventing leakage
D) Reduce surgery time
B) Less traumatic
At what angle should the intestine be transected to preserve blood flow to the antimesenteric side?
A) 30-40 degrees
B) 90 degrees
C) 50-60 degrees
D) 70-80 degrees
C) 50-60 degrees
Which suture pattern is placed first during jejunojejunostomy to avoid difficulty due to rapid edema formation?
A) Antimesenteric border
B) Mesenteric border
C) Submucosal layer
D) Seromuscular layer
B) Mesenteric border
Which suture pattern is preferred for jejunojejunostomy to reduce the risk of adhesions?
A) Gambee method
B) Interrupted Lembert pattern
C) Simple continuous pattern
D) Cushing pattern
B) Interrupted Lembert pattern
What was the short-term survival rate for strangulating lesions using the interrupted Lembert pattern?
A) 100%
B) 75%
C) 85%
D) 93%
D) 93%
Which complication was observed in a horse that had a continuous anastomosis pattern?
A) Anastomotic impaction
B) Leakage
C) Adhesions
D) Fibrosis
A) Anastomotic impaction
What is the main problem associated with small intestinal anastomoses?
A) Infection
B) Partial or complete obstruction
C) Hemorrhage
D) Leakage
B) Partial or complete obstruction
What range of lumen reduction is seen in equine jejunal anastomoses in cadaver studies?
A) 10-25%
B) 15-44.6%
C) 30-50%
D) 5-15%
B) 15-44.6%
At what time frame after surgery can tissue remodeling restore the lumen size to normal?
A) 2 weeks
B) 3 months
C) 6 months
D) 1 year
C) 6 months
What is the major disadvantage of using stapling instruments in jejunojejunostomy?
A) Time-consuming
B) Tissue damage
C) Expense
D) Increased risk of leakage
C) Expense
What size staples are preferred for equine gastrointestinal anastomosis?
A) 2.8-mm staples
B) 3.8-mm staples
C) 4.8-mm staples
D) 5.0-mm staples
C) 4.8-mm staples
Which healing method is preferred to avoid adhesions in anastomosis?
A) Appositional healing
B) Second intention healing
C) Serosal-to-serosal contact
D) Evagination of the edges
C) Serosal-to-serosal contact
What complication can arise from overinversion of the seromuscular layer during anastomosis?
A) Adhesions
B) Postoperative leakage
C) Anastomotic stenosis
D) Infection
C) Anastomotic stenosis
Which suture pattern can expose less foreign material to the serosa, reducing the risk of adhesions?
A) Interrupted Lembert
B) Continuous Lembert
C) Cushing pattern
D) Simple continuous
C) Cushing pattern
What is the risk of using the Cushing pattern during jejunojejunostomy?
A) Leakage
B) Fibrosis
C) Purse-string effect
D) Impaction
C) Purse-string effect
What percentage lumen reduction is seen with two-layer anastomosis at 21 days post-surgery?
A) 28%
B) 44%
C) 35.6%
D) 50%
C) 35.6%
Which suture material is recommended to minimize foreign material along the anastomosis?
A) 0 PDS
B) 3-0 PDS
C) 0 Vicryl
D) 3-0 Vicryl
B) 3-0 PDS
What is the preferred suture spacing for an interrupted Lembert pattern in jejunojejunostomy?
A) 5-7 mm
B) 10-15 mm
C) 8-10 mm
D) 12-14 mm
C) 8-10 mm
Which stapled technique is commonly used for equine small intestine due to size constraints?
A) Side-to-side stapled anastomosis
B) End-to-end stapled anastomosis
C) Functional end-to-end anastomosis
D) Circular stapled anastomosis
A) Side-to-side stapled anastomosis
What is a potential complication of a side-to-side stapled anastomosis?
A) Intussusception
B) Leakage
C) Adhesion formation
D) Delayed obstruction
D) Delayed obstruction
What is the recommended precompression time for tissue before firing staples?
A) 5 seconds
B) 10 seconds
C) 15 seconds
D) 20 seconds
C) 15 seconds
What was found to be a complication of the stapled side-to-side anastomosis in the equine study?
A) Shortened duration of postoperative ileus (POI)
B) Increased risk of adhesions
C) Lower survival rates
D) Increased risk of intussusception
A) Shortened duration of postoperative ileus (POI)
What complication was observed with functional end-to-end stapled anastomosis in ponies?
A) Intussusception
B) Adhesion formation
C) Leakage
D) Stomal stenosis
A) Intussusception
What is the major disadvantage of using skin staples for jejunojejunostomy?
A) Increased surgery time
B) Bulky anastomosis
C) Inconsistent placement
D) Increased risk of leakage
B) Bulky anastomosis
How many staples are typically used in a skin staple anastomosis?
A) 10-20
B) 30-40
C) 50-70
D) 80-90
C) 50-70
What pattern is recommended for anastomosis to minimize inversion in the seromuscular layer?
A) Cushing pattern
B) Continuous Lembert
C) Interrupted Lembert
D) Gambee method
C) Interrupted Lembert
Which pattern is more likely to purse-string the bowel and reduce lumen size?
A) Simple continuous pattern
B) Interrupted Lembert pattern
C) Cushing pattern
D) Gambee method
C) Cushing pattern
What stapler size is more likely to cause full closure of the anastomosis in equine cadavers?
A) 2.8-mm
B) 3.8-mm
C) 4.8-mm
D) 5.0-mm
B) 3.8-mm
What is the main advantage of using the Parker-Kerr technique for side-to-side stapling?
A) Decreased surgery time
B) Reduces risk of intussusception
C) Creates blind stumps effectively
D) Improves tissue apposition
C) Creates blind stumps effectively
Which stapled method realigns itself into an end-to-end configuration during healing?
A) Side-to-side stapled anastomosis
B) Functional end-to-end stapled anastomosis
C) End-to-end stapled anastomosis
D) Jejunoileostomy
B) Functional end-to-end stapled anastomosis
Which is a major complication of excessive seromuscular inversion during jejunojejunostomy?
A) Leakage
B) Postoperative stenosis
C) Adhesions
D) Lumen dilation
B) Postoperative stenosis
What pattern is described as posing less risk for adhesion formation than the Lembert pattern?
A) Simple continuous pattern
B) Cushing pattern
C) Interrupted Lembert pattern
D) Gambee method
B) Cushing pattern
What technique involves precompression of tissues for 15 seconds to improve staple apposition?
A) Functional end-to-end stapling
B) Side-to-side stapling
C) End-to-end stapling
D) Parker-Kerr technique
A) Functional end-to-end stapling
What is a benefit of using the interrupted Lembert pattern over the continuous Lembert pattern?
A) Faster to place
B) Less risk of leakage
C) Reduces anastomotic impaction
D) Decreases stenosis
C) Reduces anastomotic impaction
Which complication is less likely with hand-sewn end-to-end anastomosis compared to stapled side-to-side anastomosis?
A) Leakage
B) Postoperative ileus
C) Adhesion formation
D) Intussusception
B) Postoperative ileus
How does second intention healing affect anastomosis in equine small intestine?
A) Promotes quicker recovery
B) Leads to inflammation and adhesions
C) Reduces lumen size
D) Prevents leakage
B) Leads to inflammation and adhesions
What pattern was found to have a lower risk of postoperative ileus in stapled jejunojejunostomy?
A) Functional end-to-end stapled
B) Side-to-side stapled
C) Hand-sewn end-to-end
D) Parker-Kerr technique
B) Side-to-side stapled
What is a potential advantage of jejunoileal anastomosis over jejunocecal anastomosis?
A) Faster recovery time B) Preservation of the ileocecal valve C) Lower infection rates D) Easier surgical technique
B) Preservation of the ileocecal valve
Which pattern is recommended to minimize inversion in jejunoileal anastomosis?
A) Continuous B) Interrupted C) Everted D) None of the above
A) Continuous
Which factor is important for favorable long-term survival in jejunoileostomy?
A) Absence of postoperative colic B) Greater repeat celiotomy C) Lack of anesthesia D) Faster feeding resumption
A) Absence of postoperative colic
What percentage of small intestinal anastomoses can be jejunocecal or ileocecal?
A) 15-20% B) 25-40% C) 36-68% D) 70-85%
C) 36-68%
Why should the ileal stump be kept as short as possible?
A) To prevent infection B) To avoid intussusception into the cecum C) To improve healing time D) To reduce ischemia
B) To avoid intussusception into the cecum
What is one proposed method to reduce problems from an ischemic ileal stump?
A) Increasing antibiotics B) Suturing omentum over the suture line C) Using a larger incision D) Oversewing the ileal artery
B) Suturing omentum over the suture line
What complication can arise from deep ileal transection?
A) Adhesions B) Large mesenteric defects C) Intestinal rupture D) Ileal necrosis
B) Large mesenteric defects
What surgical tool is recommended for distal transection down to the ileocecal orifice?
A) TA-90 B) GIA stapler C) Babcock forceps D) Saw technique
A) TA-90
What is the recommended size of staples for distal ileal transection?
A) 3.5 mm B) 4.8 mm C) 5.2 mm D) 6.0 mm
B) 4.8 mm
What tool is used to elevate the cecum in an end-to-side jejunocecal anastomosis?
A) GIA stapler B) Babcock forceps C) Kocher clamp D) Metzenbaum scissors
B) Babcock forceps
What pattern is used to appose the jejunum to the cecum in a jejunocecal anastomosis?
A) Cushing B) Lembert C) Parker-Kerr D) Interrupted sutures
A) Cushing
Why is it important to close the mesenteric defect in jejunocecal anastomoses?
A) To prevent ischemia B) To avoid herniation of small intestine C) To minimize infection D) To reduce scar formation
B) To avoid herniation of small intestine
What is one potential advantage of side-to-side jejunocecal anastomosis over end-to-side?
A) Lower cost B) Larger stoma C) Shorter recovery time D) Higher long-term survival
B) Larger stoma
Which method of jejunocecal anastomosis may have a higher rate of postoperative colic and reflux?
A) Hand-sewn method B) GIA stapling without oversewing C) Lembert pattern D) Continuous suture method
B) GIA stapling without oversewing
What condition is more common in horses after jejunocecostomy compared to jejunojejunostomy?
A) Colic B) Infection C) Adhesion formation D) Gastric rupture
C) Adhesion formation
What surgical procedure is considered to create a larger stoma with fewer postoperative problems?
A) End-to-end jejunocecal anastomosis B) Side-to-side jejunocecostomy C) Hand-sewn jejunojejunostomy D) End-to-side ileocecostomy
B) Side-to-side jejunocecostomy
In jejunocecostomy, what complication can arise due to poor closure of the ileal stump?
A) Stomal edema B) Volvulus C) Abscessation D) Adhesion
C) Abscessation
Why is a side-to-side technique for jejunocecostomy sometimes preferred?
A) Less likelihood of volvulus B) Faster procedure C) Larger stoma with fewer complications D) Less need for repeat celiotomy
C) Larger stoma with fewer complications
What is the recommended suture pattern for the final layer of an enterotomy closure?
A) Simple continuous B) Cushing C) Interrupted Lembert D) Parker-Kerr
B) Cushing
What is the typical initial intravenous fluid rate for a 450-kg horse post-surgery?
A) 100 mL/h B) 500 mL/h C) 250 mL/h to 1 L/h D) 2 L/h
C) 250 mL/h to 1 L/h
What can enhance healing of a small intestinal anastomosis?
A) Complete rest of the bowel B) Gradual reintroduction of intestinal contents C) Continuous use of antibiotics D) Avoidance of physical movement
B) Gradual reintroduction of intestinal contents
Which complication can arise from failure to oversew the staples in a stapled jejunocecostomy?
A) Hemorrhage B) Leakage C) Tissue necrosis D) Ischemia
B) Leakage
What is the median survival time for horses after jejunocecostomy?
A) 30 months B) 50 months C) 70 months D) 90 months
D) 90 months
Which factor may contribute to higher complication rates after stapled jejunocecostomy?
A) Poor blood supply B) Staple failure at tissue edges C) Excessive inversion D) Incomplete mesenteric closure
B) Staple failure at tissue edges
What is a characteristic feature of horses with small intestinal strangulation?
A) Dehydrated colonic contents B) Enlarged cecum C) Intestinal torsion D) Blood-stained stool
A) Dehydrated colonic contents
Which antibiotic protocol is recommended after small intestinal surgery?
A) Single dose after surgery B) Broad-spectrum antibiotics for 3 to 5 days C) Antibiotics for 7 days minimum D) No antibiotics to avoid resistance
B) Broad-spectrum antibiotics for 3 to 5 days
What can be used to rule out another disease and provide a biopsy in suspected equine grass sickness (EGS)?
A) Jejunal enterotomy B) Ileal biopsy C) Cecal biopsy D) Gastric lavage
B) Ileal biopsy
GIA-100 Premium stapler with disposable cartridge used for
a side-to-side jejunocecostomy.
Which technique is used to remove gas from a distended small intestine in cases of strangulation?
A) Enterotomy B) Ileostomy C) Suction through a needle-tunneled technique D) Manual decompression
C) Suction through a needle-tunneled technique
What is a major risk of jejunocecostomy in cases of extensive ileal necrosis?
A) Stomal edema B) Abscess formation C) Ileal rupture D) Reflux esophagitis
C) Ileal rupture
How can small intestinal atony be reduced postoperatively?
A) Administration of neostigmine B) Early feeding C) Electrolyte therapy D) Shortening surgical time
B) Early feeding
Why is it essential to perform early diagnosis of ileal strangulation?
A) Prevent rupture B) Preserve vascular supply C) Avoid ischemia D) Reduce colic
C) Avoid ischemia
What is a primary reason for postoperative intestinal stasis?
A) Sepsis B) Over-sedation C) Adhesion formation D) Pain management issues
C) Adhesion formation
What is the first clinical sign of intestinal perforation?
A) Severe abdominal pain B) Fever C) Dehydration D) Rapid pulse
A) Severe abdominal pain
hich suture material is recommended for anastomoses?
A) Polypropylene B) Nylon C) Absorbable monofilament D) Catgut
C) Absorbable monofilament
What post-surgical complication can be avoided by correct mesenteric closure?
A) Intestinal torsion B) Herniation C) Stomal leakage D) Peritonitis
B) Herniation
What is the survival rate of horses that undergo surgery for small intestinal strangulation?
A) 10-20% B) 30-40% C) 50-60% D) 70-80%
D) 70-80%
What is a risk of prolonged postoperative ileus in horses?
A) Weight gain B) Small intestinal torsion C) Adhesion formation D) Decreased bowel function
C) Adhesion formation
What was the reported short-term survival rate for horses that had surgery of the small intestine from 2000 to 2017?
A) 68% to 100%
B) 80% to 90%
C) 50% to 70%
D) 90% to 95%
A) 68% to 100%
What was the short-term survival rate reported in a large series of cases from one hospital in 1982?
A) 68%
B) 82%
C) 75%
D) 90%
B) 82%
Which type of lesions in horses tend to have lower survival rates?
A) Small colon diseases
B) Lesions involving the small intestine
C) Lesions involving large intestine
D) Skin lesions
B) Lesions involving the small intestine
What has shown little progress in the decades from 1982 to 2017 regarding surgeries?
A) Survival rates
B) Reduction in complications such as postoperative reflux
C) Length of surgery
D) Types of anesthesia used
B) Reduction in complications such as postoperative reflux
What common postoperative complication is associated with small intestinal surgery?
A) Pneumonia
B) Colic
C) Laminitis
D) Arthritis
B) Colic
n experienced surgeons, what is their outcome compared to less experienced surgeons?
A) Worse survival rates
B) Significantly better survival rates
C) Marginally better survival rates
D) No difference in survival rates
B) Significantly better survival rates
Which type of obstruction shows variability in survival rates based on the type of colic?
A) Simple obstruction
B) Strangulation obstruction
C) Both simple and strangulation obstruction
D) None of the above
C) Both simple and strangulation obstruction
What factor appears to be associated with increased risk in horses with strangulation in the EF?
A) Higher preoperative total protein
B) Shorter duration of surgery
C) Lower preoperative total protein
D) Younger age
C) Lower preoperative total protein
What is the prognosis after correction of lesions without resection?
A) Worse than resection
B) Similar prognosis as resection
C) Better prognosis than after resection
D) No data available
C) Better prognosis than after resection
Which surgical procedure is associated with a higher likelihood of postoperative complications?
A) Jejunojejunostomy
B) Jejunocecostomy
C) Ileostomy
D) Colostomy
B) Jejunocecostomy
What age group tends to have a similar survival rate after surgery for small intestinal strangulating lesions?
A) Foals
B) Horses 16 years or older
C) Young horses under 2 years
D) Senior horses 20 years or older
B) Horses 16 years or older
What is a common misconception regarding geriatric horses presenting with colic?
A) They require more surgery
B) They are less prone to complications
C) Prognosis based on age is often underestimated
D) They are more resilient than younger horses
C) Prognosis based on age is often underestimated
Heavy draft horses that undergo small intestinal surgery have what compared to lighter breeds?
A) Better survival rates
B) Higher mortality rates
C) Lower complication rates
D) More efficient recovery
B) Higher mortality rates
What complication is particularly high in American Miniature Horses post-surgery?
A) Colic
B) Hyperlipidemia
C) Laminitis
D) Fractures
B) Hyperlipidemia
hat complication is reported as one of the most common after small intestinal surgery?
A) Lung infection
B) Colic
C) Laminitis
D) Neuropathy
B) Colic
According to studies, what factor positively influences survival rates in horses undergoing small intestinal surgery?
A) Experience level of the surgeon
B) Size of the horse
C) Type of anesthesia used
D) Time of surgery
A) Experience level of the surgeon
Which type of obstruction generally has better survival rates in horses?
A) Simple obstruction
B) Strangulation obstruction
C) Ileus obstruction
D) Partial obstruction
A) Simple obstruction
In horses, the risk of non-survival was associated with what surgical factor?
A) Duration of surgery
B) Number of surgeons present
C) Type of anesthesia
D) Surgeon’s age
A) Duration of surgery
green cartridge what size is the staple?
Green cartridges contain staples that have a leg length of 4.8 mm, crown width of 4.0 mm, and closed height of 2.0 mm
What is the blue cartridge size? Leg Length and crown width of staple and close height
the blue cartridge have a leg length of 3.5 mm, a crown width of 4.0 mm, and closed height of 1.5 mm
Which surgical method is associated with increased postoperative abdominal pain?
A) Jejunojejunostomy
B) Jejunocecostomy
C) Ileostomy
D) Gastrectomy
B) Jejunocecostomy
What is a common misconception affecting geriatric horses during surgery?
A) They need less anesthesia
B) Their prognosis is worse based on age
C) They recover faster
D) They require more post-operative care
B) Their prognosis is worse based on age
Draft horses weighing over 680 kg that have colic surgery generally face what outcome?
A) Shorter recovery time
B) Higher survival rates
C) More postoperative complications
D) Lower rates of anesthesia
C) More postoperative complications
What tends to be a leading cause of euthanasia in geriatric horses?
A) Old age alone
B) Concurrent disease
C) Age misconceptions
D) Complex surgical needs
C) Age misconceptions
What percentage of foals younger than 14 days survived to maturity following colic surgery?
A) 5%
B) 10%
C) 25%
D) 45%
B) 10%
In comparative outcomes, what factor did not affect survival in horses with colic?
A) Concurrent illness
B) Type of surgery
C) Age of horse
D) Duration of surgery
A) Concurrent illness
What postoperative complication has been noted for foals following surgery?
A) Hyperventilation
B) Ileus
C) Caustic poisoning
D) Peritonitis
B) Ileus
What percentage of horses survived to surgery for EF entrapment if occurred within 8 hours of colic onset?
A) 25.1%
B) 45.1%
C) 75.6%
D) 12.1%
C) 75.6%
What percentage of horses survived to surgery for EF entrapment if occurred within 12 hours of colic onset?
A) 25.1%
B) 45.1%
C) 75.6%
D) 12.1%
B) 45.1%
Boshuizen et al 2020 EVJ Increased incidence of caecocaecal and caecocolic intussusceptions in horses and the possisble relation with cyathostominosis what is the mean age of horses:
A) 3 years old
B) 4 years old
C) 1 year old
D) 2 years old
C) 1 year old and 11 months (range 7 months to 3 years old)
Boshuizen et al 2020 EVJ Increased incidence of caecocaecal and caecocolic intussusceptions in horses and the possisble relation with cyathostominosis what was the most common intussusception?
A) 64% caecocolic
B) 32% caecocolic
C) 36% caecocaecal
D) 52% caeccocaecal
A) 64% caecocolic
Boshuizen et al 2020 EVJ Increased incidence of caecocaecal and caecocolic intussusceptions in horses and the possisble relation with cyathostominosis - cyathostominae infection was confirmed in :
A) 86% cases
B) 72% cases
C) 66% cases
D) 46% cases
A) 86% cases 12/14 of cases
Giusto et al 2024 Return of showjumping horses to sporting activity after colic surgery what was the % that returned to competition?
A) 78%
B) 89.1%
C) 63.6%
D) 31. 2%
A) 78% returned to competition
89.1% competed at the same or higher level,
63.6% of the showjumping horses that underwent colic surgery were alive after 2 years
Showjumping horses can make a successful return to competition after colic surgery, with the majority performing at the same or higher level as before the procedure.
Intraoperative photograph from Case 1 that had caecocolic
intussusception; this figure shows the invaginated caecum
after reduction from the colon, prior to final reduction of the
caecal component.
Fig 1: Abdominal sonogram obtained ventrally on the right side from Case 1. Two mural surfaces of an intussusception are present. The blue arrow depicts the mural surface of the intussuscepiens and the black arrow depicts the mural surface of the intussusceptum.
Appearance of the caecum after complete reduction of
the caeco-colic intussusception in Case 1.
Givan et al 2023 Risk factors associated with development of colitis in horses post-exploratory laparotomy are:
A) pelvic flexure enterotomy, postoperative leukopenia or leukocytosis
B) pelvic flexure enterotomy, plasma lactate 2-4 mmol/L
C) pelvic flexure enterotomy, postoperative leukopenia or leukocytosis, lactate 2-4 mmol/L
D) postoperative leukopenia or leukocytosis, lactate 2-4 mmol/L
C) pelvic flexure enterotomy, postoperative leukopenia or leukocytosis, lactate 2-4 mmol/L
Givan et al 2023 Patients with colitis had a survival to discharge rate similar to patients without colitis?
Yes 95% compared to 93%.
Givan et al 2023 What was the main disadvantage of having postop colitis?
Patients diagnosed with colitis had a longer median length of hospitalisation (9 days; range 2–21) compared with patients without colitis (7 days)
Giusto et al Feb 2024 EVJ Anastomotic techniques for small intestinal obstruction in horses. A scoping review, what was the survival reate in all types of anastomosis?
Both short- and long-term survival rates consistently exceed 70% for all types of anastomosis (jejuno-jejunal, jejuno-ileal, and jejunocaecal).
Long et al August 2023 EVJ Use of multiple admission variables better predicts intestinal strangulation in horses with colic than peritoneal or the ratio of peritoneal:blood l-lactate concentration: What was the primary objective of the study regarding horses with colic?
A) To identify a single variable that can predict strangulating obstruction (SO).
B) To compare various clinical variables for predicting strangulating obstruction (SO) and strangulating obstruction with small intestinal lesions (SO-SI).
C) To determine the effectiveness of surgical intervention in horses with colic.
D) To evaluate the cost-effectiveness of treating colic in horses.
B) To compare various clinical variables for predicting strangulating obstruction (SO) and strangulating obstruction with small intestinal lesions (SO-SI).
Long et al August 2023 EVJ What was the area under the curve (AUC ROC) for the final multivariable model predicting SO?
A) 0.75
B) 0.81
C) 0.91
D) 0.95
C) 0.91
Long et al August 2023 EVJ Use of multiple admission variables better predicts intestinal strangulation in horses with colic than peritoneal or the ratio of peritoneal:blood l-lactate concentration: Which of the following variables was included in the final multivariable model for predicting strangulating obstruction (SO)?
A) Reflux volume
B) Rectal temperature
C) Duration of colic
D) Age of the horse
B) Rectal temperature
- What is one of the key advantages of standing flank laparotomy over ventral midline laparotomy in horses with colic?
A) It provides better access to all regions of the abdominal cavity
B) It is performed more frequently and is the gold standard
C) It avoids the need for general anaesthesia and is less expensive
D) It is associated with a significantly higher survival rate
C) It avoids the need for general anaesthesia and is less expensive
Lopes et al EVJ 2021Standing flank laparotomy for colic: 37 cases Which of the following was associated with the highest survival rate following standing flank laparotomy?
A) Horses with peritoneal disease
B) Horses with small intestinal (SI) disease
C) Horses with caecum and/or large colon (LC) disease
D) Animals that underwent resection-anastomosis of the SI or LC
C) Horses with caecum and/or large colon (LC) disease
Lopes et al EVJ 2021Standing flank laparotomy for colic: 37 cases Which of the following intraoperative complications was mentioned in the abstract as negatively affecting the outcome during standing flank laparotomy?
A) Partial typhlectomy in one horse
B) Severe intolerance to abdominopelvic exploration in two ponies
C) Enterotomy in four animals
D) Resection-anastomosis of the small intestine
B) Severe intolerance to abdominopelvic exploration in two ponies
Lopes et al EVJ 2021Standing flank laparotomy for colic: 37 cases What was identified as a major limitation of the study on standing flank laparotomy in horses?
A) Lack of access to the ventral midline of the abdominopelvic cavity
B) Systemic administration of analgesics providing insufficient peritoneal analgesia
C) High rate of postoperative complications related to general anaesthesia
D) Presence of a large control group that complicated the analysis
B) Systemic administration of analgesics providing insufficient peritoneal analgesia
Rodriguez Pozo 2021 Peritoneal bile acids concentration in adult horses with hepatic and gastrointestinal disorders In which group of horses was the peritoneal bile acids concentration (PBAC) found to be the highest?
A) Healthy horses
B) Gastrointestinal (GI) obstructive group
C) Gastrointestinal (GI) ischaemic-inflammatory group
D) Hepatic group
D) Hepatic group
Which of the following findings regarding PBAC was statistically significant?
A) PBAC was significantly lower in the hepatic group compared to the control group
B) PBAC was significantly higher in nonsurvivor horses compared to survivor horses
C) PBAC was similar across all groups of horses with gastrointestinal disease
D) PBAC had no significant prognostic value for horses with abdominal pain
B) PBAC was significantly higher in nonsurvivor horses compared to survivor horses
Rodriguez Pozo 2021 Which of the following was NOT identified as a limitation in the study of PBAC in horses?
A) The retrospective nature of the study
B) The need for a larger number of horses with abdominal disease
C) The small sample size of healthy horses
D) The study’s focus on only two disease categories (hepatic and gastrointestinal)
A) The retrospective nature of the study
Rodriguez Pozo 2021 What is the potential clinical role of PBAC according to the study’s conclusions?
A) As a definitive diagnostic tool for gastrointestinal obstruction
B) To assess liver function in healthy horses
C) As both a diagnostic and prognostic tool for hepatic and gastrointestinal diseases
D) To exclusively diagnose gastrointestinal ischemic-inflammatory conditions
C) As both a diagnostic and prognostic tool for hepatic and gastrointestinal diseases
Gandini 2021 Jejunocaecal Anastomosis and Ileal Stump Inversion
What complication has been associated with leaving a necrotic ileal stump in jejunocaecal anastomosis?
A) Ileal perforation
B) Poor outcomes and complications
C) Hemorrhage at the caecocolic orifice
D) Infection and necrosis of the jejunal loop
B) Poor outcomes and complications
Gandini et al 2021 What material was used to secure the device for elective inversion of the necrotic ileal stump?
A) Electrical wire
B) Surgical thread
C) Hemp tape
D) Nylon string
C) Hemp tape
Gandini et al 2021 How many clinical cases were reported in this study that utilized the new device for ileal stump inversion?
A) Two
B) Four
C) Six
D) Ten
B) Four
Gandini et al 2021 What was the main limitation of the study on the new device for ileal stump inversion?
A) Limited number of hospitals involved
B) High rate of post-surgical infections
C) Lack of randomization in case selection
D) Small number of cases admitted to a single hospital
D) Small number of cases admitted to a single hospital
Lisowski et al 2022 Use of quantitative real-time PCR to determine the local inflammatory response in the intestinal mucosa andmuscularisof horses undergoing small intestinal resection
Which gene was NOT included in the study’s analysis of inflammatory response in equine colic surgery?
A) IL1β
B) IL6
C) TNF
D) IL10
D) IL10
Lisowski 2022 Use of quantitative real-time PCR to determine the local inflammatory response in the intestinal mucosa andmuscularisof horses undergoing small intestinal resection
Which tissue was harvested from horses undergoing colic surgery for gene expression analysis?
A) Stomach lining
B) Healthy margins of the resected small intestine
C) Caecal mucosa
D) Jejunal villi
B) Healthy margins of the resected small intestine
Lisowski 2022 et al EVJ Use of quantitative real-time PCR to determine the local inflammatory response in the intestinal mucosa andmuscularisof horses undergoing small intestinal resection
Which inflammatory gene showed a significant association with the development of post-operative reflux (POR) in colic cases?
A) IL1β
B) CCL2
C) TNF
D) PTGS2
C) TNF
Lisowski et al 2022 What was the main conclusion from the gene expression analysis in the study?
A) Gene expression was uniform across different colic cases
B) Upregulation of inflammatory genes occurred in horses undergoing colic surgery
C) No significant difference was found in gene expression between colic and control groups
D) IL6 was the only gene linked to post-operative complications
B) Upregulation of inflammatory genes occurred in horses undergoing colic surgery
Fitzgerald et al 2023 Expression of theGCGgene and secretion of active glucagon-like peptide-1 varies along the length of intestinal tract in horses -
What was the main objective of the in vivo portion of the study on glucagon-like peptide-1 (aGLP-1)?
A) To study the effects of different insulin levels on horses
B) To identify the sequence of the exons of the GCG gene in horses with and without insulin dysregulation (ID)
C) To assess the role of GLP-1 in equine digestion
D) To measure GLP-1 response in different breeds of horses
B) To identify the sequence of the exons of the GCG gene in horses with and without insulin dysregulation (ID)
Fitzgerald et al 2023 What was used to measure aGLP-1 secretion in tissue explants during the in vitro studies?
A) ELISA
B) PCR
C) Immunohistochemistry
D) Western blot
A) ELISA
Fitzgerald et al 2023 Which part of the equine intestine showed the greatest variation in mRNA concentrations of the GCG gene?
A) Stomach
B) Duodenum
C) Ileum
D) Large intestine
D) Large intestine
Fitzgerald et al 2023 What was concluded regarding the GCG gene sequence in horses with and without ID?
A) There was a significant variation in exon sequences between the two groups
B) No difference was found in the exons of the GCG gene
C) GCG expression was lower in horses with ID
D) Genetic variants contributed to aGLP-1 secretion differences
B) No difference was found in the exons of the GCG gene
Nemoto et al 2021 Distribution of equine coronavirus RNA in the intestinal tracts of experimentally infected horses - What is the primary route of transmission for Equine Coronavirus (ECoV)?
A) Airborne transmission
B) Direct contact with infected blood
C) Faecal-oral transmission
D) Aerosolized respiratory droplets
C) Faecal-oral transmission
Nemoto et al 2021
Which intestinal section had the greatest quantity of ECoV RNA in Horse 1?
A) Jejunum
B) Ileum
C) Caecum
D) Colon
B) Ileum
Nemoto et al 2021 On which intestinal structure was ECoV RNA located in all three horses studied?
A) Intestinal crypts
B) Luminal surface
C) Muscularis mucosa
D) Submucosa
B) Luminal surface
Nemoto et al 2021 What was a main limitation of the study regarding Equine Coronavirus (ECoV)?
A) Lack of real-time PCR usage
B) The absence of severe cases for analysis
C) Difficulty in detecting ECoV RNA
D) Unreliable faecal sampling
B) The absence of severe cases for analysis
Mathys 2023 Duodenoduodenal intussusception in a 16-year-old GermanWarmblood mare F I G U R E 1 Transrectal ultrasonographic image of the intussusception obtained at the right craniodorsal aspect of the abdomen. Note theconcentric multi-layered appearance of the intestinal walls (ring sign). Hyperechoic mesenterial fat is invaginated with the intussusceptumwithin the intussuscipiens. The arrowheads show the lumen of the intussusceptum. The arrows point to the intestinal wall of theintussusceptum. The stars indicate separate mucosal layers of the intussuscipiens
Boorman et al 2021 F I G U R E 1 Intraoperative photograph of a 22-year-old geldingundergoing standing flank laparotomy and distal jejunal enterotomyfor treatment of ileal impaction. The non-sterile surgeon (left) isintroducing a medium bore nasogastric tube into the enterotomyand digitally clamping the intestine around it to prevent backflowof water. A non-sterile assistant (bottom right) is pumping waterinto the nasogastric tube. The sterile surgeon (top right) is ballotingthe impaction to facilitate its breakup and massaging luminalcontents orally towards the enterotomy site. Once the impactionwas cleared, the sterile surgeon was able to feel contents movingthrough the axially located ileocaecal orifice. A second non-sterile assistant (top) continuously poured sterile saline over theenterotomy site to prevent errant intestinal contents from enteringthe peritoneal cavity.
F I G U R E 1 Intraoperative image of Case 1: A 6-week-old Arabianfoal with right indirect inguinal herniation of the pelvic flexure.The pelvic flexure was reassessed following reduction and wasfound viable. The white arrow points to the vaginal tunic after theherniated colon was reduced
F I G U R E 2 Intraoperative image of Case 2: An 8-week-oldArabian foal with direct left inguinal hernia of the ascendingcolon. The pelvic flexure is shown herniated (white arrow), beforereduction attempts. The caecum (black arrow) is exteriorisedthrough the ventral midline incisionF I G U R E 3 Intraoperative image of Case 2: An 8- week-oldArabian foal with direct left inguinal hernia of the ascending colon.Reduction was performed through a combination of inguinal (whitearrow); and a ventral midline (black arrow) incisions. The pelvicflexure is shown immediately after reduction (black arrowhead); it isseverely hyperaemic and oedematous with petechiae
F I G U R E 3 Intraoperative image of Case 2: An 8- week-oldArabian foal with direct left inguinal hernia of the ascending colon.Reduction was performed through a combination of inguinal (whitearrow); and a ventral midline (black arrow) incisions. The pelvicflexure is shown immediately after reduction (black arrowhead); it isseverely hyperaemic and oedematous with petechiae
Gandini et al 2021 EVE What pathological feature suggests the progressive involvement of the distal bowel in cases of ileal hernia?
A) Uniform occlusion of the distal bowel
B) Greater pathological severity in the distal segments
C) Less severe pathological features proceeding proximal to distal
D) Complete necrosis of the distal bowel
C) Less severe pathological features proceeding proximal to distal
Gandini et al 2021 According to the hypothesis proposed in the study, why does the involvement of the ileum eventually prevent further progression of intestinal segments into the hernia?
A) The ileocaecal valve prevents further peristalsis
B) The hernia closes when the ileum enters
C) The ileum is too large to enter the hernial port
D) The empty intestine is pulled back orally by reverse peristalsis
A) The ileocaecal valve prevents further peristalsis
Mathys et al 2022What was identified as being associated with the duodenoduodenal intussusception in the mare?
A) Small intestinal obstruction
B) Jejunal muscular atrophy
C) Pseudodiverticulum and duodenal muscular hypertrophy
D) Mesenteric torsion
C) Pseudodiverticulum and duodenal muscular hypertrophy
Mathys et al 2022 EVE What was the prognosis for the mare following the diagnosis of duodenoduodenal intussusception?
A) Excellent, following surgical correction
B) Poor, leading to euthanasia
C) Moderate, with intensive care needed
D) Good, with a chance of recovery after medical treatment
B) Poor, leading to euthanasia
What was a key difference between the two cases of inguinal herniation in Arabian foals?
A) One was a large colon hernia, and the other was a small intestine hernia
B) One was a right indirect hernia, and the other was a left direct hernia
C) One required the removal of the testis, while the other did not
D) One involved a mare, and the other involved a gelding
B) One was a right indirect hernia, and the other was a left direct hernia
What was the outcome for both foals after surgical treatment of the inguinal hernias?
A) One foal recovered, but the other was euthanized
B) Both foals died post-surgery
C) Both foals recovered well and had good long-term outcomes
D) Both foals required reoperation due to complications
C) Both foals recovered well and had good long-term outcomes
Boorman and Caldwell 2021 What was the primary surgical technique used to resolve the ileal impaction in the Quarter Horse?
A) Celiotomy under general anesthesia
B) Standing right flank laparotomy with enterotomy
C) Laparoscopic-assisted celiotomy
D) Midline exploratory laparotomy under sedation
B) Standing right flank laparotomy with enterotomy
Why was a standing right flank laparotomy chosen over a celiotomy under general anesthesia in this case?
A) It was faster and more effective
B) It was less expensive and more appropriate due to the horse’s health or financial constraints
C) The horse had a history of intolerance to anesthesia
D) It provided better visualization of the impacted area
B) It was less expensive and more appropriate due to the horse’s health or financial constraints
FIGURE 1 (a) Image depicting the right traumatic thoracic wound of Horse 1 with a 10-mm
laparoscopic cannula inserted through the
12th ICS, cranial is to the left. (b) Intra-operative
laparoscopic image of Horse 1 depicting the diaphragmatic defect on the right dorsal
quadrant. Please note that the image is bloody, and the diaphragmatic edges are torn due to the acute nature of the injury. A: liver and B:
diaphragm. (c) Intra-operative
laparoscopic image of Horse 1 depicting the closed diaphragmatic rent after direct suturing with barbed
suture. Please note that the image is bloody due to the acute nature of the injury. (d) Intra-operative
laparoscopic image of Horse 2 depicting
the diaphragmatic rent on the left dorsal quadrant. Please note that the rent presents round and fibrous edges due to its chronicity. C:
Spleen. (e) intra-operative
laparoscopic image of the automated suturing device used to close the diaphragmatic defect of Horse 2. (f) Intra-operative
laparoscopic image of Horse 2 depicting diaphragmatic rent closure after suturing the defect with barbed suture and an automated
suturing device.
According to Kamus et al 2021 Use of barbed suture for thoracoscopic repair of diaphragmatic hernias: 3 cases Where were performed the portals of the surgery?
First, a 10-mm
camera
portal was created at the 12th ICS just ventrally to the longissimus
dorsi muscle. Exploration of the pleural cavity revealed a
12–13
cm diameter diaphragmatic defect in the right dorsal quadrant. Two standard instrument portals
were then created at the 13th (4–5
cm distally to the first portal)
and 14th ICS (aligned with the camera portal).
According to Kamus et al 2021 - How was the dorsal hernia closed?
the laceration was closed with absorbable
barbed suture (0 USP, V-Loc
180, 15 cm, Covidien, Medtronic Ltd)
placed in a simple continuous fashion. Two suture lines
were required for correct closure of the defect as the margins of
the defect were friable. The
According to Kamus et al 2021 - How did they correct the pneumothorax?
Thoracic
negative pressure was re-established
at the end of the surgery by
aspiration of the right pneumothorax. A 16F thoracic drain was
placed in the proximal aspect of the left 13th ICS to drain a contralateral
pneumothorax that developed during surgery. Lastly, a
32F abdominal drain was placed ventrally in the right aspect of
the abdomen to perform post-operative
lavage given the suspicion
of abdominal contamination during the injury
