L10: LA Basic Gastro Sx (Freeman) Flashcards
1 and 2 cause of death in horses
1: old age
2: colic
nonischemic intestinal lesions
- intraluminal obstructions and displacements
- assoc. with very high survival rate
- ie. enterolith, food material
ischemic instestinal lesions
- strangulating lesions, infarction
- sx needed promptly
what can’t be exteriorized in exploratory celiotomy?
beginning and end of large colon, stomach, and transverse colon, part of ileum
enteroliths
- usually in R dorsal colon
- often form around initis (FB)
Right Dorsal displacement of the colon (RDDC)
- Colon rotates laterally on its long axis around the cecum, to become positioned to the right of the cecum between the cecum and body wall
- causes obstruction w/ ischemia, pain
Nephrosplenic Ligament Entrapment =
left dorsal displacement of colon
Dx of NSLE/LDDC
CS,Hx, rectal palpation, U/S
Tx of NSLE/LDDX
- IV phenylephrine infusion and mild exercise over 15 mins
- rolling
- sx
- prevention: closure of nephrosplenic space
Large Colon Volvulus
RVC usually rotates clockwise over RDC if standing behind horse
- results in ischemia
- most common in postpartum mare
- severe pain
- distended abd
about 60% of horses with epiploic foramen entrapment have history of:
cribbing
Inguinal hernia in what breeds?***
Standardbreds Tennessee Walkers Saddlebred -prevent with closed castration -congenital prob. in foals -emergency in adults; painful, swollen
tapeworms may play role in:
intussusception
how much of SI can be resected?
60-70%
ligate divide stapler
for anastomoses (?)
layers of intestine wall
Mucosa (villi, crypts, muscle layer)
Submucosa
Seromuscular layer (circular and longitudinal muscle serosa)
suture patterns for intestinal anastomoses
lembert and cushing. Both are inverting patterns, but don’t want to invert too much or can cause narrowing of lumen!
jejunocecostomy
- connects jejunum to cecum
- re-establishes the continuity of the gastrointestinal tract after ileal resection
Parker-Kerr suture pattern
one used to close the stump of a hollow viscus, e.g. in intestinal anastomosis. A Cushing suture pattern is put in first over the top of the bowel clamp which is then gradually withdrawn and the suture pulled tight. A layer of Lembert pattern is then used to oversew the first row.
use what forceps for enterotomy closure?
Babcock forceps
how much of large colon can be resected?
80%
colopexy
- for horses prone to recurrent displacements
- attaches band of ventral colon to body wall
omentum in LA ventral midline closure?
NO (LA more prone to adhesion, and omentum doesn’t hold suture well)
use what to get good tension on suture?
sliding half hitch
aftercare
- IV fluids, abx (penicillin, gentamicin)
- flunixin meglumine (NSAID)
- pass stomach tube if indicated (relieves SI reflux)
- water at 12hrs
- small hay at 18-24hrs, then at 4hr intervals
- ICU checks
- repeated and increased to full feed by 72-96hrs
what percent success for strangulating and non-strangulating lesions in general?
non-strangulating: 90%
strangulating: 80%
