Exam 1: Lecture 5/6 - Surgery of the intestines Flashcards
what is the definition of enterotomy
an incision into the intestine
what is the definition of enterostomy
removal of a segment of intestine
what is the definition of intestinal resection and anastomosis
an enterostomy with reestablishment of continuity between the divided cells
what is the definition of intestinal plication (AKA enteroenteropexy)
surgical fixation of one intestinal segment to another
what is the definition of enteropexy
fixation of an intestinal segment to the body wall or another loop of intestine
what is the definition of colopexy
surgical fixation of the colon
what is the definition of colectomy
partial or complete resection of the colon
what is the definition of typhlectomy
resection of the cecum
what is the definition of colostomy
surgical creation of an opening between the colon and the surface of the body
what is the definition of tenesmus
straining to defecate
what is the definition of dyschezia
pain or discomfort on defecation
what is the definition of hematochezia
passage of stools that contain red blood
what is the definition of melena
passage of tarry stools (digested blood)
what are the indications for SI sx
- GI obstruction (via tumors, intussusception, FB, masses)
- trauma (perforation and ischemia)
- malpositioning
- infection
- diagnostic/supportive procedures (biopsy, culture, cytology, feeding tubes)
what are the indications for sx of the LI (large intestine)
- obstruction (tumors, intussusception, granulomatous masses)
- perforation (colonic inertia, chronic inflammation)
what does visual exam provide us with
mental status, temperament, nutritional state, comfort
what can abdominal palpation help ID for SI issues
pain, thickened intestine, abdominal masses, or mispositioned organs
what do we look for on PE of large intestine
- colon is normally palpable
- feces vs masses on palpation
- sub lumbar LN enlargement may be palpable
- lyphadenomegaly suggestive of metastasis
- rectal exam
what are the things we look for on rectal exam
- shape and symmetry of pelvis
- mucosal thickness
- pelvic canal masses
- intraluminal masses
- distal strictures
for the PE of the LA, should we palpate anus, anal sacs, and do a fecal exam?
yes!!! look for thickening, enlargement, pain, blood, mucous, or parasites
what are the most important things to do for preoperative management of intestinal sx
- obtain minimum database
- localize lesion
- correct hydration, electrolyte, and acid-base abnormalities
- transfusion if needed
- withhold food
- administer prophylactic abx if needed
why do we do hematologic and biochem profiles prior to SI sx
to ID concurrent systemic disease like renal, hepatic, hypoadrenocorticism, hypercalcemia, diabetes mellitus, or pancreatitis
other than finding underlying disease, why else can hematologic and biochem profiles be helpful
to direct preoperative therapy
T/F: abnormalities should be corrected prior to anesthesia if possible
true!! better for the patient if we are able prior to sx