GI SX- 2 Flashcards
What is the main blood supply for SI & venous drainage
Cranial mesentery artery
Portal vein
Differentiation in CS between partial/ distal obstruction &complete
Less profuse diarrhea with intermittent signs
What intestinal changes are associated with simple complete obstructions?
Ischemia, devitalization and body wall edema that occurs orad to the obstruction
What blood gas changes are associated with duodenal obstruction?
Hypochloremia hyponatremia metabolic alkalosis
D/T loss of secretions (becomes severely dehydrated)
What blood gas changes are associated with low jejunal obstructions?
Metabolic acidosis (resorptive capacity maintained)
Linear foreign bodies- anchor point (cat v dog)
Cat- under tongue
Dog- pylorus (can be under tongue )
What type of obstruction is linear foreign bodies
Partial obstruction
Often has nonspecific CS
Where would a string embed in a linear foreign body?
Mesenteric side
Dog: Max SI diameter compared to L5 height
> 2x have greater chance of obstruction
Cat: Max SI diameter
Should nit exceed 12 mm
Or SI diameter : cranial L2 endplate >3
What are linear obstruction pattern
Accordian/ plication
Comma shaped
How is a strangulation obstruction different from mechanical?
Diffuse gas dilation
Entertomy- Pro
Less risk of surgical dehiscence
Retains absorptive capacity
Where should you make your incision in an enterotomy?
Aborad, because tissue unhealthy/inflamed orad so harder to heal
Intestinal R&A cons
Longer surgical time
Greater risk of leakage
Greater potential for stricture
Weight loss & diarrhea
Short bowel syndrome
Malabsorption and malnutrition after SI resection (50-85%)
-proximal resection better tolerated than distal (b/c ileum & ileocecolic region is responsible for nutrient absorption)
Abdominal policeman
Greater omentum that patches leak and hastens revascularizaton
Why should colonic surgery not be performed?
Segmental circulation, anaerobic population, collagen lysis exceeds synthesis and collagenase production increased
Healing phases
Inflammatory phase (all leakage occuring during this time)
Proliferative phase
Maturation phase
What healing phase is the phase we are concerned with dehisence?
Inflammatory phase
-recheck 3-5 days
Intussusception signalment
Dogs > cat
GSD & siamese
Intussusception etiology
Hypermotility, distemper, parvo, intestinal parasitism and bowel manipulation
Intussusception CS
Inapptetence, vomiting, tenesmus &melena
US: bulls eye
How to manage intussusception?
Manual reduction, R&A
- recurrence: enteropexy and enteroplication
Enteroplication:
Last resort for intussusception- segment of intestine side by side to reduce recurrence
Intestinal volvulus and torsion- signalment
Young adult, male large breed [GSD]
Intestinal volvulus and torsion CS
CV Collapse, vomiting, abd distension, hematochezia
Intestinal volvulus and torsion prognosis
Grave; survivors have short bowel syndrome
