Kapitel 86 – Peritoneum and retroperitoneum Flashcards
What are the natural openings of the caudal abdomen and what do they contain?
Inguinal canal: containing the external pudenal vessels, genitofemoral vessels, genitofemoral nerve and the spermatic cord in males.
Vascular lacunae: femoral artery and vein, lymphatic vessels and the saphenous nerve.
What are the boarders of the epiploic foramen and why it this foramen of surgical significance?
a. bounded dorsally by the caudal vena cava and ventrally by the portal vein
b. Bleeding from the liver can be temporarily arrested by placing a finger through the epiploic foramen just cranial to the pylorus and curling the finger ventrally to occlude the hepatic artery and portal vein.
What are the three portion of the greater omentum?
a. Bursal portions (most important portion)
b. The splenic portion - extends to the hilus of the spleen to form the gastrosplenic ligament
c. Veil portion – containing the left limb of the pancreas (smallest portion)
What does parts of the lesser omentum give rise to?
The hepatoduodenal ligament and hepatogastric ligament.
What organs and structures are considered retroperitoneal?
a. Kidneys
b. Ureters for most of their length
c. Adrenal glands
d. The aorta
e. Caudal vena cava
f. Lumbar lymph nodes
What is the normal colloid pressure of peritoneal fluid?
28 mmhg
What is the normal intra-abdominal pressure?
2-7,5 cm H2O
What organ dysfunctions are described in acute abdominal compartment syndrome?
a. acute pulmonary failure secondary to compressive atelectasis and impaired gas exchange
b. increased intrathoracic pressure leading to increased pleural and pericardial pressures
c. decreased venous return to the heart
d. acute renal failure with marked oliguria
e. intestinal ischemia with resultant bacterial translocation
f. hepatic ischemia resulting in increased liver enzyme levels
g. increased intracranial pressure leading to decreased cerebral perfusion and neuronal injury
h. venous thrombosis and thromboembolism
i. abdominal wall ischemia or necrosis
When should surgical decompression be considered in abdominal compartment syndrome?
When intraabdominal pressure nears 30 cm H2O, particularly in oliguric animals
What is associated with adhesion formation in the abdominal cavity?
a. Ischemia
b. Endotoxemia
c. Intestinal manipulation
d. Bowel distension
e. Desiccation of serosal surfaces.
How can you minimize/prevent adhesion?
a. Prevent of tissue drying
b. Gentle tissue handling
c. thorough hemostasis
d. precise suture placement
e. complete removal of blood clots and foreign debris
f. thorough lavage
The severity of clinical signs of peritonitis is proportional to the degree of elevation of proinflammatory cytokines. Which ones in particular?
TNF-α, IL-8, and IL-6
A number of intraperitoneal substances are known adjuvants in peritonitis. These substances either worsen the local and systemic inflammatory response or worsen the prognosis in bacterial peritonitis. Which are those substance?
a. gastric mucin
b. bile salts
c. hemoglobin
d. barium
was is the mortality rate of dogs with septic peritonitis?
55% in dogs with at least one failed organ system and 94% in those with concurrent hypotension needing vasopressor therapy.
How is peritonitis classified? Which one is most common in small animals?
a. primary or secondary
b. acute or chronic
c. localized or generalized
d. septic or aseptic
–> Acute generalized secondary septic peritonitis
Give an example of primary peritonitis in small animals
Feline coronavirus infection resulting in feline infectious peritonitis
What is the mortality rate in digs that developed intestinal anastomotic leakage?
85 % despite aggressive treatment
What are the two most common bacterial isolates in peritonitis secondary to bowel perforation?
E. coli and Bacteroides fragilis.
What volume of fluid can be detected on physical examination by ballottement?
A peritoneal fluid volume of 10 ml/kg BW
Are cats with septic peritonitis usually
Hypothermic
During abdominal auscultation, what is a persistent sign of peritonitis?
Lack of bowel sounds due to reflex intestinal ileus.
Which is the single most useful test for peritonitis?
Abdominocentesis
What are early radiological signs of peritonitis?
patchy, flaky, or mottled appearance of the abdominal organs and blurred borders between bowel loops and abdominal organs
what minimum blood test are recommended when suspecting peritonitis?
a. Complete blood count
b. total protein and albumin
c. urea nitrogen
d. electrolytes
e. glucose
f. serum lactate
g. blood gas analysis
