Lecture 21: Exploratory Celiotomy (Exam 3) Flashcards
Define celiotomy
Incision into the abdominal cavity
Define Laparotomy
Flank incision
Define acute abdomen
Sudden onset signs (distention, pain, vomiting) referable to the abdomen
Define Abdominal evisceration
Herniation of peritoneal contents through the body wall w/ exposure of the abdominal viscera
What are the diagnostic reasons for an abdominal exploratory surgery
- Biopsies
- Visualization
What are the therapeutic reasons for an abdominal exploratory
- GDV
- Severe hemorrhage
- Colonic perforation
- Foreign body removal
- Evisceration
What is the number one cause of post op major abdominal evisceration in a recent study
Ovariohysterectomy (OHE)
T/F: Surgery can always be delayed until one is certain that the px will benefit from it
False it cannot always be delayed
What should be done in pre op
- Hx
- PE findings
- Radiographic studies
- Ultrasonic studies
- Lab findings
Will depressed/lethargic animals always so pain
No
How long should you observe trauma px for & why
- > or equal to 8 to 12 h
- B/c hemorrhage may not show up for 3 to 4 hours
What are some general observations that need to be observed
- Attitude & posture of px
- Temperature
- Respiratory rate & effort
- HR & rhythm
- Abdominal auscultation, percussion, & palpation
- Serial PE
What blood samples should be taken
- Hematocrit
- Total protein
- Glucose
- Blood urea nitrogen
- Complete blood count
- Other tests as indicated
How can urine collection been taken
- Cystocentesis (Ultrasound, palpation, blind stick)
- Catheterization
- Indwelling catheter to measure urine output
What critical communication should be said to the owner
- Mention the chance of post op infection
- Mention the possibility of wound dehiscence
- “There is a chance that we may not find any gross abnorms in surgery”
- ” There is a chance that he/she won’t make it through the sx”
- “There is a chance that we could find something so bad that I will need to speak to you during surgery”
If you speak to the owner about these things before surgery what is more likely to happen
The owner is more likely to deal w/ these situation better should they occur
What are some things that need to be considered before anesthetic
- Underlying disease
- Age of animal
- Condition of animal
- Length & type of surgical procedure
- Remember pain management
What type of surgeries usually don’t warrant prophylactic antibiotic
Surgeries less than 1 & 1/2 hours long
What does the white line mean
“Cut here”
Why is the linea alba easier to locate near the umbilicus
Becomes thinner back near the pubis
Describe the canine linea alba
- Site of insertion for the external abdominal oblique muscle via the rectus sheath
- ~ 1 cm wide & 1 mm thick @ the cranial location but @ the caudal end it is ~ 1 mm wide & much thicker
what should be done before incision & after closing
Always count sponges
Where should the incision be made
From the xyphoid to pubis to explore all abdominal organs (can be adjusted by the case)
If it looks bad on the outside what will the client assume
That whatever you did on the inside must be bad too