L10: LA Basic Gastro Sx (Freeman)

Question 1

1 and 2 cause of death in horses

Answer 1

1: old age
2: colic

Question 2

nonischemic intestinal lesions

Answer 2

• intraluminal obstructions and displacements
• assoc. with very high survival rate
• ie. enterolith, food material

Question 3

ischemic instestinal lesions

Answer 3

• strangulating lesions, infarction

- sx needed promptly

Question 4

what can’t be exteriorized in exploratory celiotomy?

Answer 4

beginning and end of large colon, stomach, and transverse colon, part of ileum

Question 5

enteroliths

Answer 5

• usually in R dorsal colon

- often form around initis (FB)

Question 6

Right Dorsal displacement of the colon (RDDC)

Answer 6

• 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

Question 7

Nephrosplenic Ligament Entrapment =

Answer 7

left dorsal displacement of colon

Question 8

Dx of NSLE/LDDC

Answer 8

CS,Hx, rectal palpation, U/S

Question 9

Tx of NSLE/LDDX

Answer 9

• IV phenylephrine infusion and mild exercise over 15 mins
• rolling
• sx
• prevention: closure of nephrosplenic space

Question 10

Large Colon Volvulus

Answer 10

RVC usually rotates clockwise over RDC if standing behind horse

• results in ischemia
• most common in postpartum mare
• severe pain
• distended abd

Question 11

about 60% of horses with epiploic foramen entrapment have history of:

Answer 11

cribbing

Question 12

Inguinal hernia in what breeds?***

Answer 12

Standardbreds
Tennessee Walkers
Saddlebred
-prevent with closed castration
-congenital prob. in foals
-emergency in adults; painful, swollen

Question 13

tapeworms may play role in:

Answer 13

intussusception

Question 14

how much of SI can be resected?

Answer 14

60-70%

Question 15

ligate divide stapler

Answer 15

for anastomoses (?)

Question 16

layers of intestine wall

Answer 16

Mucosa (villi, crypts, muscle layer)
Submucosa
Seromuscular layer (circular and longitudinal muscle serosa)

Question 17

suture patterns for intestinal anastomoses

Answer 17

lembert and cushing. Both are inverting patterns, but don’t want to invert too much or can cause narrowing of lumen!

Question 18

jejunocecostomy

Answer 18

• connects jejunum to cecum

- re-establishes the continuity of the gastrointestinal tract after ileal resection

Question 19

Parker-Kerr suture pattern

Answer 19

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.

Question 20

use what forceps for enterotomy closure?

Answer 20

Babcock forceps

Question 21

how much of large colon can be resected?

Answer 21

80%

Question 22

colopexy

Answer 22

• for horses prone to recurrent displacements

- attaches band of ventral colon to body wall

Question 23

omentum in LA ventral midline closure?

Answer 23

NO (LA more prone to adhesion, and omentum doesn’t hold suture well)

Question 24

use what to get good tension on suture?

Answer 24

sliding half hitch

Question 25

aftercare

Answer 25

• 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

Question 26

what percent success for strangulating and non-strangulating lesions in general?

Answer 26

non-strangulating: 90%

strangulating: 80%