Colic Flashcards
Clinical signs of colic
pawing trying to lay down rolling abrasions recumbent muscle fasciculation looking at flank restlessness kicking at abdomen sweating
Colic history
age, time of onset, degree, any previous treatment, previous colic, previous colic surgery, last passed faeces, management, worming
Colic PE
demeanor TPR GI borborygmi CV status abdominal distension
What pulse rate is worrying?
over 60
If febrile what does it indicate?
colitis
enteritis
peritonitis
First diagnostic / therapeutic test and why?
Pass a NGT - see if any reflux (over 2L is abnormal) , see type of reflux, relieve any gastric distension so no stomach rupture
Diagnostic tests
NGT
Rectal exam
abdominocentesis ( will take a while before get change after rupture etc)
ultrasound
clinical pathology - PCV , total protein, lactate
3 main reasons for colic
distension - gas, fluid, ingesta
inflammation - non strangulating
ischaemia - strangulating or thombotic
What can distension be caused by (not gas, fluid, ingesta)
non-strangulating lesion - impaction, displacement
strangulating lesion - volvulus, torsion, incarceration
motility dysfunction - enteritis, grass sickness, post- surgical ileus
6 types of non-strangulating lesions
spasmodic colic impaction displacement enteritis / ileus peritonitis typhiocolitis
all medically treated
L int strangulating lesions
colon torsion
intussusception
both surgical
S int strangulating lesions
volvulus strangulating lipoma epiploic foramen entrapment inguinal / scrotal hernia intussusception diaphragmatic hernia mesenteric rent
all surgical
When to refer?
suspicion of strangulating lesion poor response to analgesia SI lesions CVS compromise abd distension non- resolving impactions
Indications of a medical lesion
low grade pain normal CVS normal abdo shape and borborygmi no reflux palpation normal / mild gas / impaction
Indications of a surgical lesion
acute onset, severe pain CVS compromised hypovolaemia (gut ischaemia) distended abdomen absent of quiet borborygmi profuse sweating over 2L / abnormal reflux abnormal rectal exam congested MM (endotoxaemia from rupture)
