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Alimentary > Colic Decision Making > Flashcards

Colic Decision Making Flashcards

1
Q

Give 2 examples of simple colics

A

Spasmodic, impaction

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2
Q

Give 3 examples of potentially complicated colic

A

Displacement, enteritis, colitis

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3
Q

What is a definitive surgical colic?

A

Strangulating lesion

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4
Q

What is a common cause of non-GI colic?

A

Pariparturient mare uterus

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5
Q

What are 3 general causes of abdominal pain?

A
  • Distension (MECHANICAL: gas, fluid, ingesta or FUNCTIONAL)
  • Inflammation/ischaemia of intestine
  • Irritation of peritoneum
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6
Q

What are the 2 forms of mechanical obstruction?

A
  • Non-strangulating eg. impaction , displacement

- Strangulating eg. volvulus, torsion, incarceration

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7
Q

Where are impactions usually seen?

A
  • pelvic flexure and RDC -> thin transverse colon flexure
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8
Q

Where are displacements usually seen

A

LI

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9
Q

What are functional obstructions?

A

Motility (paralytic) dysfunction - ileus etc. [blood supply not compromised]
- Enteritis, grass sickness [equine dysautonomia], post-surgical ileus

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10
Q

What are cuases of inflammation? Are these strangulating?

A

Enteritis, colitis, typhlitis, peritonitis

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11
Q

What are causes of ischaemia?

A
  • Volvulus, torsion, incarceration
  • Thrombotic
  • Parasitic [migrating strongylus vulgaris larvae, coagulopathy, DIC] <- rarely seen now due to Ivermectin success, incidence may ^ due to resistence
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12
Q

Outline the 6 non-strangulating lesions that may cause colic

A
  • Spasmodic colic
  • Impaction
  • Displacement
  • Enteritis/ileus
  • Typhocolitis
  • Peritonitis
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13
Q

In horses where does the cause of diarrhoea ALWAYS originate?

A

LI

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14
Q

How do SI pathologies manifest?

A

Spontaneous reflux

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15
Q

What time frame do you have for saving strangulating lesions?

A

~ 1 hour = viable intestine (distension of intestine and stomach)
~ 3-4hrs = Compromised intestine (leakage of blood/protein -> abdo, loss of fluid -> intestine [may -> hypovolaemic shock])
~ 6-8hrs = Dead intestine (absorption of toxins -> blood)

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16
Q

Give 7 causes of strangulating lesions of the SI to cause colic. Which is most common? Which is rare?

A
  1. Volvulus (root of mesentry)
  2. Strangulating lipoma [most common]
  3. Epiploic foramen entrapment [R abdo between portal V and caudal vena cava]
  4. Inguinal/scrotal hernia
  5. Intussusceptions
  6. Diaphragmatic hernia [rare]
  7. Mesenteric rent
17
Q

Give 2 causes of strangulating lesions of the LI to cause colic. How serious are these problems?

A
  1. Colon torsion - very severe colic.
  2. Intussusception
    - Ceaco-colic
    - Ileo-ceacal
    - Ceaco-ceacal
18
Q

What clinical signs distinguish SI lesions?

A
  • reflux (though may be absent)

- Distended SI (palpable on rectal, ultrasound)

19
Q

What clinical signs distinguish LI lesions?

A

± abdo distension

  • impaction/gas accumulation palpable on rectal
  • distension of LI palpable on rectal
  • no reflux (usually)
20
Q

Give 2 SI conditions requiring medical Tx

A
  • Enteritis/ileus

- Grass sickness

21
Q

Give 7 conditions requiring surgical Tx

A
  • Volvulus (root of mesentry)
  • Strangulating lipoma
  • Epiploic foramen entrapment
  • Inguinal/scrotal hernia
  • Intussusceptions
  • Diaphragmatic hernia
  • Mesenteric rent
22
Q

How is grass sickness Dx?

A

Biopsy (ileal?)

23
Q

Give 6 LI conditions requiring medical Tx

A
  • Spasmodic colic
  • Impaction
  • Left dorsal displacement
  • Right dorsal displacement
  • Colitis
  • Typhlocolitis
24
Q

Give 2 LI conditions requiring surgical Tx

A
  • Colon torsion

- Non-resolving displacement and impactions

25
Q

In what situations should a colic be referred?

A
  • SI lesions (Sx likely, medical cases need intense Tx)
  • Conditions requiring intensive medical Tx (enteritis/colitis)
  • Non-resolving impactions (IV fluids, surgery if displaced)
  • Recurring/chronic colic for further work up
26
Q

How much does a medical colic cost to treat in referral centres? Surgical colic? Colitis/enteritis?

A

~ £1000-£3000
~ £4000-£7000
~ £2000-£5000

27
Q

How should referral be decided wrt owner?

A
  • age of horse
  • willingness to undergo abdo surgery
  • insurance (type of cover, be aware colic may have been removed if suffered previously)
28
Q

SEE LECTURE FOR FINDINGS ON HISTORY, PE, NGT, TX RELATED TO PROGNOSIS ETC.

A

~

29
Q

What complications can be seen <2-4 weeks post-surgery?

A
  • aneasthetic complications (1/100 die)
  • post-op colic
  • post-op ileus (reflux)
  • incisional complications (dehiscence, infection)
  • thrombosis
  • peritonitis
  • laminitis
30
Q

What complications can be seen >2-4 weeks post-surgery?

A
  • recurrent/chronic colic due to adhesions

- Incisional hernia

31
Q

What are the prognoses for

a) simple medical colic?
b) non-strangulating surgical colic?
c) strangulating SI lesion?
d) strangulating LI lesion?

A

a) 90% good
b) 70-90% good
c) guarded (without resection 60-80%; with resection 50-70%)
d) guarded/poor (wihtout reseaction 36-83%; with resection[rarely possible] 50-80%)

Alimentary (30 decks)

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