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Surgery > GIT Surgery!!!! > Flashcards

GIT Surgery!!!! Flashcards

1
Q

GIT surgery is considered clean-contaminated - which means what?

A
  • give peri-op ABs (Gram -ves, anaerobes)
  • isolation of viscus
  • change instruments/gloves
  • local lavage
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2
Q

suture choice

A

monofilament, absorbable on reverse cutting/taper needle

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3
Q

Indications for a gastrotomy/gastrectomy

A
  • gastric FBs
  • full thickness biopsy
  • resection of neoplasia (uncommon)
  • resection of devitalised tissue - GDV
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4
Q

Gastrotomy closure technique

A
  1. Closure; single layer appositional vs 2.layer appositional (mucosa then seromuscular+submucosa)
    - simple cont.
  2. Run entire GIT and explore abdo
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5
Q

gastrotomy post-op

A
  1. IVFT and lytes
  2. Gastroprotectants
  3. Pro-motility drugs (ileus)
  4. Food and water as soon as willing to eat
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6
Q

Risk factors for GDV

A
  1. Large/giant breeds (3x)
  2. Thoracic depth (conformation)
  3. Feeding practices?? large volumes of food at high speeds
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7
Q

GDV clinical signs

A
  • acute, non-productive retching
  • salivation
  • abdo distention and discomfort
  • tachypnea, dyspnea, weakness, collapse
  • pale/injected mm
  • weak peripheral pulse/pulse deficit
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8
Q

what rad view to diagnose GDV?

A

Right lateral view = large gas filled stomach with displacement of pylorus (smurf)

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9
Q

what antibiotics to treat endotoxaemia assoc. w/ GDV?

A

3rd gen cephalosporins

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10
Q

Surgical management of GDV once stable(ish)/ASAP

A
  1. reposition stomach (decompress + derotate)
  2. assess gastric and splenic viability
  3. Permanently fix antrum to right cranial abdominal quadrant
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11
Q

GDV post-op monitoring/complications

A
  • IVFT
  • ABs
  • Gastroprotectants/motility
  • Coagulopathy
  • Arrhythmia
  • Peritonitis/sepsis –> pyrexia, pain, abdo incision discharge ,
    distention
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12
Q

what are the two approaches to a prophylactic gastropexy

A
  1. Laparoscopic-assisted gastropexy

2. Open incisional gastropexy

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13
Q

Indications for splenectomy

A
  • neoplasia: haemangiosarcoma, lymphoa, histiocytic sarcoma
  • trauma/torsion
  • abscessation/splenitis (Clostridia)
  • non-responsive IMT
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14
Q

the major splenic pedicles

A
  1. Splenic
  2. Left gastroepiploic
  3. Short gastrics
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15
Q

what is the holding layer of the intestines when closing?

A

submucosa

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16
Q

size/type suture for intestinal closure

A

monofilament absorbable 3-0 to 5-0

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17
Q

risk factors for an ileocolic intussusception in young dogs

A

parasitism, enteritis, caecal inversion

18
Q

common presentation of an intestinal adenocarcinoma

A

annular, stenotic lesion in the large intestine (dogs) or jejunum (cats - siamese)

19
Q

common presentation of an intestinal lymphosarcoma

A

infiltrative, intramural disease, discrete lesion

20
Q

what is the prognosis of a cat with chronic lymphocytic lymphosarcoma?

A

2-3yrs w/ chemo

21
Q

prognosis of intestinal adenocarcinoma vs. lymphosarcoma of a dog

A

adenocarcinoma - recurrence or metastasis in 3-9months

lymphosarcoma - poor - months

22
Q

prognosis of GIST (leiomyosarcoma)

A

depends on grade - up to 12months

23
Q

CS of a high intestinal obstruction

A

vom, abdo pain

24
Q

CS of a low intestinal obstruction

A

abdominal pain, bloody, mucoid D+

25
Q

describes steps of enterotomy

A
  1. Exteriorise and pack off intestinal segment
  2. Milk the intestinal contents away from the proposed incision site
  3. Occlude the lumen with your assistant’s fingers or intestinal forceps (Doyen’s)
  4. Longitudinal incision on anti-mesenteric margin of intestine
  5. Closure: simple interrupted full thickness sutures
  6. Check closure by injecting sterile saline into intestinal lumen using 22G needle and syringe
26
Q

describe steps for intestinal resection and anastomosis

A
  1. Exteriorise segment
  2. ID section for resection
  3. Ligate arcade vessels + Mesenteric (vasa recta)
  4. Crushing forceps on part being removed - angled away from resection + non-crushing (fingers/Doyen’s) on healthy tissue (~5cm from resection site to allow room)
  5. Transect intestine away from crushing clamps
  6. Anastomosis: simple interrupted full thickness 3-0/4-0 monofilament absorbable –> work from mesenteric edge up either side
27
Q

what do you do if there is disparity in size of intestinal edges for closure after a resection?

A

make the smaller section larger with an extension of the incision longitudinally - NEVER make the larger section smaller

28
Q

what is intestinal plication?

A

pexy the transverse colon to the greater curvature of the stomach
pexy the descending colon to the left body wall
+ strategically placed seromuscular sutures along the length of intestine to prevent intuss recurrence

29
Q

common causes of obstipation

A

perineal hernia, perianal fistulas, anal sac disease, pelvic trauma/fxs, rectal strictures (neoplasia), idiopathic megacolon (cats)

30
Q

describe the technique of a subtotal colectomy

A
  1. Removal of ileocecocolic junction
  2. Preserve as much of the ileum as possible
  3. Size disparity of anastomosis
  4. Simple interrupted full-thickness closure
31
Q

how do you treat an acute rectal prolapse?

A
  1. Lubricant
  2. Epidural (morphine)
  3. Manual reduction
  4. Anocutaneous purse-string for 4-5days
  5. Stool softener
32
Q

when is a colopexy indicated?

A

indicated for extensive or repeated prolapse

33
Q

post-op considerations for rectal prolapse amputations/colopexies

A
  • stool softeners
  • epidural - straining
  • E.Collar
  • avoid rectal manipulation
  • address inciting cause
34
Q

types of primary rectal tumours dogs

A
  • adenoma/adenocarcinoma
  • lymphosarcoma
  • leiomyoma/sarcoma
35
Q

types of primary rectal tumours cats

A
  • adenocarcinoma
  • lymphosarcoma
  • leiomyosarcoma
36
Q

CS of rectal neoplasia

A
  • haematachezia
  • tenesmus
  • rectal bleeding independent of defecation
  • rectal prolapse
37
Q

what rectal tumour is commonly ‘egg like’?

A

leiomyoma

38
Q

what rectal tumour commonly forms strictures?

A

adenocarcinoma

39
Q

what rectal tumour is commonly assoc. w/ intramural thickening?

A

leiomyosarcoma

40
Q

prognosis of malignant rectal neoplasias

A

poor, recurrence likely 2-3months

41
Q

prognosis of benign rectal neoplasia

A

fair but frequent evaluation as malignant transformation possible and recurrence if inadequate resection

Surgery (22 decks)

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