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RUSVM LASx PRACTICE QUESTIONS > Exam 2: Rectal Tears and Rectal Prolapse > Flashcards

Exam 2: Rectal Tears and Rectal Prolapse Flashcards

1
Q

A rectal tear is a potentially catastrophic event

in this species

A

HORSES

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2
Q

Most rectal tears in horses occur

on the _______ aspect

A

dorsal

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3
Q

This muscle relaxant is used in horses

in order to prevent rectal tears

A

BUSCOPAN

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4
Q

A spontaneous rectal tear can occur post-foaling

in horses due to

pressure necrosis at the ____________.

A

Pelvic inlet

  • squeezes foal against pelvic inlet and squeezes rectum*
  • against rim of pelvis = crush necrosis and hole in rectum*
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5
Q

How is a rectal tear diagnosed and confirmed?

A

Sudden release of pressure felt on palpation

Sudden ability to palpate abdominal organs

Blood on sleeve

Confirmed via speculum exam of rectum or careful palpation

BARE HANDED with lube

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6
Q

Rectal tears in mares are usually dorsal

and ____________

A

longitudinal

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7
Q

When confirming rectal tear by bare hand palpation,

what meds can be used to stop rectal contractions?

A

Epidural

Xylazine/Butorphanol/Buscopan

Lidocaine enema or gel

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8
Q

The most common rectal tear classification is

Grade 1, which involves these layers of tissue

A

mucosa and submucosa

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9
Q

What tissue layers are involved in a Grade 2 rectal tear?

A

mucosa, submucosa, and MUSCULAR LAYER

may feel like a thin wall/diverticulum- feces impacted here

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10
Q

Grade 3A rectal tear involves

all layers except the ________

A

serosa

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11
Q

Grade 3b involves

mucosa, submucosa, muscular layer, serosa,

___________ and ____________

A

MESORECTUM and RETROPERITONEAL TISSUE

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12
Q

Grade 4 rectal tear extends into the ________

A

abdomen

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13
Q

A colicking horse is seen after palpation.

What are you concerned about?

A

Rectal tear

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14
Q

Septic shock and peritonitis are potential

sequela of rectal tears in horses.

Which antibiotics are used to treat this?

A

Penicillin

Gentamicin

Metronidazole

Flunixin

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15
Q

How is a rectal tear initially treated?

A

Given Antibiotics

Buscopan to reduce rectal motility

Epidural anesthesia

Gentle packing of rectum with gauze soaked in iodine

the REFER OUT!

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16
Q

Which grades of rectal tears can be treated

non-surgically and how are they treated?

A

Grade 1, 2, or 3:

Grade 1 and 2: Antibiotics + Flunixin

Grade 3: Frequent manual removal of feces + epidural anesthesia

+ peritoneal lavage

17
Q

Grade _____ rectal tears must always be treated surgically

A

Grade 4

18
Q

What surgical methods can be used

to fix a rectal tear?

A

Direct suture repair

Temporary indwelling rectal liner

Loop colostomy

19
Q

What are the indications for a loop colostomy (LOW LEFT FLANK)

in the treatment of rectal tears in horses?

A

Grade 4, maybe Grade 3

Tear > 25% of rectal diameter

Tear > 50 cm from anus

20
Q

What is the prognosis for rectal tears?

A

Grade 1: 93%

Grade 2: 80%

Grade 3: 70%

Grade 4: 6% only

21
Q

What complications are associated with Grade 3 and 4

rectal tears?

A

Cellulitis, Abscess

Toxemia, Laminitis

Intestinal adhesions

Stricture

Diverticulum

Fistula

22
Q

In regards to rectal prolapse:

is most common in younger _______ cattle

A

feedlot

23
Q

Describe the pathogenesis of

rectal prolapse in sheep

due to excessively short tail cropping

A

If cut the tail too short, you cut the coccygeus muscle,

which causes decreased support around the anus

predisposing to rectal prolapse

24
Q

Classify the rectal prolapse:

only mucosa projects through the anus

A

Type 1

25
Q

Classify the rectal prolapse:

prolapse of all layers of the rectum

A

Type 2

26
Q

Classify the rectal prolapse:

Small colon intussuscepts into rectum

A

Type 3

27
Q

Classify the rectal prolapse:

Rectum/colon intussusception through the anus

A

Type 4

28
Q

What are the most common types of rectal prolapse?

A

Types 1 and 2

29
Q

Classify this rectal prolapse:

A

Type 2:

Prolapse of all layers of the rectum

30
Q

On palpation of rectal prolapse,

a palpable trench is felt inside the rectum.

What classification does this correspond to?

A

Type 4 rectal prolapse

31
Q

How would you treat a Type 1 or 2 rectal prolapse?

A

Replacement and purse string sutures

+

Perirectal injection of iodine

(causes scar tissue formation, like a permanent purse string suture and keeps condition from recurring)

32
Q

What is the treatment of choice for rectal prolapse

that has necrotic, ulcerated, or traumatized mucosa, but

healthy underlying tissue?

A

Submucosal resection

(tissue anchored every 90 degrees- 4 simple interrupted sutures)

33
Q

What are the 2 methods of amputation that

can be used to treat rectal prolapse?

A

Overlapping mattress suture amputation

Stair Step amputation (reduced risk of stricture formation!)

34
Q

How is a Type 4 rectal prolapse treated surgically?

A

Celiotomy, Resection, and Anastomosis

(must open up cavity to make sure mesentery has not torn

and lost blood supply to GI)

RUSVM LASx PRACTICE QUESTIONS (24 decks)

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