GI Tract Surgeries Flashcards
examples of oral surgeries?
dentals - scale and polish or extractions
oral tumours - older patients
- present facial swelling and halitosis
foreign body removal - more common with dogs
- sticks, bone and chewed-up toys
examples of oesophageal surgeries?
foreign body - partial or complete
- cause regurgitation and dehydration - hypovolaemic shock
- a gastrostomy tube may be placed due to damage
stricture - muscle spasm causing partial obstruction
- regurgitation likely
- stretch the stricture with an endoscope
- liquid diet for few days to prevent more damage
gastric surgery examples?
foreign body
- persistent or intermittent vomiting
- problem straight away or when blocking pylorus
gastric dilation-volvulus - emergency
- accumulation of ingesta and gas causes rotation of stomach and occludes oesophagus
- also occludes blood vessels to the heart causing cardiac compromise
- right lat x-ray to confirm rotation
risk factors of GDV?
large single daily meals
exercise after feeding
breeds - GSD, Irish Wolfhound, Iirsh Setters, Great Danes
underweight and fast eaters
how to prep for GVD surgery?
decompress stomach
- either pass tube or needle through abdo wall
treat for shock and stabilise
- use hartmanns as contains potassium
- GDVs rapidly lose K+
have on an ECG
- allows for baseline and safer monitoring
- quick signs of compromise
position in dorsal for midline incision
- clip and prep most of abdomen
how does a gastroplexy work?
treatment for GDV
- stomach is anchored onto the chest wall
- prevents further volvulus
- but doesn’t prevent further dilation
then a stomach tube is placed for recovery
what post-op care is most important with GDV patients?
maintain on Hartmann
- monitor potassium levels
metoclopramide may be needed
- stimulates gastric motility
monitor for ventricular dysrhythmias
client education on risk factors to avoid reoccurrence
small intestine surgery examples?
enteroctomy - FB removal
- cats - linear FBs cause the intestine to concertina which blocks the lumen
- dogs - balls or plastic toys block one area of lumen
intussusception - often young patients - fatal
- intestine crunches up
- peristalsis still occurs but restricted area
- compromised area can die off as blood supply cut off
what considerations need to be made when performing surgery on the small intestine?
ensure areas worked on are lifted out
- avoids contamination of gut contents in the abdomen
keep moist with sterile saline swabs
rapid heat loss is common as opening up large surface area
what considerations need to be made when performing surgery on the large intestine?
it has a high bacterial load and a slow healing rate
- so antibiotics are essential
enemas are contraindicated
- can cause tenesmus - unproductive straining
example of large intestine surgery?
Colectomy - removal of parts of colon
Causes:
- chronic constipation in cats
- chronic conditions causing intestine to lose function (eg neoplasia)
Clinical signs
- regurgitations, dehydration and hypovolemic shock
Technique
- resection and anastamosis
Post-op care
- often anorexic - feeding tube may be needed
- d+ also likely due to less water absorption
example of rectal/anal surgery?
removal or rectal polyps/tumours
clinical signs
- tenesmus, bleeding (red/fresh), discomfort
technique
- pull out - rectum everted through anus to excise
-less invasive
post-op care
- reduce tenesmus (can damage stitches and wound breakdown) - laxative to help pass
- analgesia, anti-inflammatory drugs
- dietary fibre - keep colon moving
how should you care for a post-ex-lap patient?
get up[ and moving asap
- may need to place urinary catheter if no moving
encourage small but regular feeds once up and moving
- if not place a feeding tube
- feeding stimulates blood flow to the gut which aids in healing
