GIT

Question 1

What part do you incise in an enterectomy?

Answer 1

Antimesenteric boarder

Question 2

Indications for a colonopexy and what is it?

Answer 2

Attaching the colon to the abdominal wall to treat bouts of recurring anal prolapse following dystocia or severe D+

Question 3

Possibilities for Dx of FB in oesophagus or megaoesophagus? (4 methods)

Answer 3

Palpation, endoscopy, X-Ray, Contrast study (barium if not perforated, iodine if perforation is suspected)

Question 4

in what parts of the oesophagus are FB’s likely to become stuck? (3 potential places)

Answer 4

Apertura thoracis cranialis,
Base of the heart,
Hiatus oesophagii

Question 5

what is a pyloromyotomy?

Answer 5

Surgical procedure in which an incision is made into the muscle layers of the stomach (specifically the pylorus) to allow the widening of the pylorus and outflow of gastric content into the SI

Question 6

Indications for pyloromyotomy?

Answer 6

Pyloric stenosis (muscle hyperplasia)

Question 7

3 basic steps of pyloromyotomy?

Answer 7

incise abdominal cavity
Take hypovascular ventral side of the pylorus and hold between two fingers of your non-dominant hand
incuse through serosa and muscularis allowing the mucosa to bulge out of the incision

Question 8

Types of pyloroplasty? (3 types)

Answer 8

Heineke-Mikulicz
Fredet-Ramstedt
Y-U

Question 9

Principle of a pyloroplasty?

Answer 9

Widening of the pylorus to allow for passage of gastric content into the SI

Question 10

Cx of GDV?

Answer 10

Tachypnoea 
Pytalism 
Distended abdomen 
Painful abdomen 
V+

Can also see hypovolemic shock symptoms (tachycardia, pale MM, weak peripheral pulse, slow CRT, dyspnoea)

Question 11

Which vessels are used in fluid therapy of GDV? (2 possibilities, 1 contraindicated)

Answer 11

Cephalic or jugular 
NOT saphenic (VVCau obstruction)

Question 12

What type os arrthymia is common in GDV

Answer 12

Ventricular tachycardia

Question 13

What is the therapy for acute tachycardia in GDV?

Answer 13

Lidocaine intracardially (2-4ml/kg)

Question 14

Surgical therapy in GDV (4 steps)

Answer 14

Midline laparotomy
Gastric decompression (Gastrocentesis or intubation)
Gastropexy
Gastrectomy (if any necrotic tissue present)

Question 15

What is gastropexy?

Answer 15

Attaching the stomach to the abdominal wall to prevent recurrent GDV or as prophylactic measure in predisposed breeds

Question 16

4 types of gastropexy

Answer 16

Tube (gastrostomy)
Incisional (muscle flap)
Belt loop
Circumcostal

Question 17

Which ligament can we release for better surgical access to the pylorus and duodenum?

Answer 17

Hepatogastric ligament

Question 18

Which layer of the small intestine wall plays the most important role in healing?

Answer 18

Submucosa

Question 19

What is an omentopexy?

Answer 19

Adhering the greater omentum to an organ to improve blood supply and promote healing, can also be attached to the abdominal wall to promote blood flow from portal to systemic

Question 20

What parameters give an indication of intestinal vitality?

Answer 20

Colour
Peristaltic movement
Pulse (blood supply)

Question 21

Enterectomy is?

Answer 21

Resection of part of the intestine that has been damaged or is necrotic (new ends are anastomosed)

Question 22

When are the signs of obstruction of the oesophagus caused by presence of the 4th PAO diagnosed?

Answer 22

When the animal is weaned and switches from liquid milk to solid food

Question 23

What is hiatal hernia?

What are the 3 types?

Answer 23

Protrusion of part of the stomach into the thorax via the hiatus oesopagii
Types: Sliding, rolling or combination

Question 24

List 3 pyloric diseases

Answer 24

Muscular hyperthrophy (pyloric stenosis)
Pythiosis (fungal infection)
Neoplasia
Foreign body obstruction

Question 25

Bleeding and gastric ulceration are caused by?

Answer 25

Stress NSAID's (iatrogenic) (suppression of mucous production) Physical trauma to the mucosal layer Mast cell tumours (over production of gastrin) Reduction in prostaglandins

Question 26

Common causes of prolonged healing of oesophagus after incision suturing:

Answer 26

``` Peristalsis (constant movement) segmental blood supply Respiration lack of serosa tension at the surgical site ```

Question 27

Which way does the pylorus move in GDV?

Answer 27

Dorsally and to the right (wraps around cardia and oesophagus)

Question 28

Max isotonic fluid for GDV? | other fluid values you know?

Answer 28

Isotonic: +/- 90ml/kg/hr (hypertonic 7% saline (4–5 mL/kg over 5–15 minutes), hetastarch (5–10 mL/kg over 10–15 minutes), mixture of 7.5% saline and hetastarch (dilute 23.4% saline with 6% hetastarch for a 7.5% solution; administer at 4 mL/kg over 5 minutes))

Question 29

Hypertonic solution is ...%

Answer 29

7%

Question 30

How do decompress stomach during GDV?

Answer 30

Intubation per os | Gastrocentesis

Question 31

CARDIAC effects of GDV?

Answer 31

Hypovolemic shock Cx | Tachycardia, weak peripheral pulse, pale MM, prolonged CRT, dyspnoea

Question 32

What drugs can’t be used during GDV therapy?

Answer 32

NSAID's

Question 33

Sutures used in the GIT?

Answer 33

2 layer suture 1 - Lambert, Halsted, Cushing 2 - Simple interrupted/continuous, Gambee

Question 34

What are the most common surgeries of the stomach?

Answer 34

``` Gastrotomy gastrectomy gastrostomy gastropexy pylorotomy (pyloromyotomy) ```

Question 35

2 Methods of apposing the stomach wall edges? how do we distinguish these methods of joining?

Answer 35

Sero-muscular | crushing (including the submucosa)

Question 36

What 3 layers are sutured in the stomach?

Answer 36

Submucosa, muscularis, serosa