Peritonitis Flashcards
Hansen, JVECC, 2019:
Gastrostomy tube usage in septic peritonitis
Survival rate?
75% of the cases developed septic peritonitis from what source?
Complication rate?
What % had G-tube-related complications?
Hansen, JVECC, 2019:
75% survival rate
75% had a gastrointestinal source of septic peritonitis
50% complication rate
33% had G-tube-related complications
Rodriguez, Vet Surg 2018
What did this study find in regards to the biomechanical properties of the feline ventral abdominal wall?
-The POU region achieved lower loads to failure.
- Load to failure was greater in males compared with females.
-No difference was detected between full-thickness
and fascia-only closure OR between Vicryl and PDS closure
-Failure most commonly occurred by tearing of suture through tissues.
-Tissue failure with suture line loosening occurred mainly in the 5 x 5-mmSBSI group.
- Thickness of linea alba decreased from cr to cd
Rossanesse, JSAP 2019
What congenital condition may be predisposed in Cavalier King Charles Spaniels? And what did this study find?
Congenital pleuroperitoneal diaphragmatic hernia (rare) caused by a defect in the dorsolateral diaphragm (L crus).
The hernia configuration was consistent in all cases
Defects of the L crus of the diaphragm –> herniation of the stomach into thorax w/ possible tension gastrothorax
Matiasovic, JSAP 2018
What was found with thoracic/abdominal wall impalement in 54 dogs?
Impalement w/ wooden objects (n=34),
Thoracic cavity was most commonly penetrated (n=37).
CT: sensitive and specific to ID wooden material in 64% and 88% of 11 cases.
Thoracotomy was performed in 56%, celiotomy in 20% and FB or its fragments were retrieved during Sx in 37% of cases.
Complications occurred in 19 dogs (35%): 68% were minor and 32% major.
Survival rate for thoracotomy cases was 93% (n=30).
Overall long-term survival was 90%.
Morgan, Vet Surg 2020
What was found in this retrospective study of 128 dogs with PPDH diagnosed?
91 dogs tx w/ sx and 37 dogs conservatively
Dogs treated surgically were younger, more likely to be sexually intact, more likely to have C/S from PPDH & more likely to have other congenital abnormalities compared with dogs treated conservatively.
97% of ST dogs were discharged from hospitals.
Intraoperative and postop complications
were reported in 22% and 41% of dogs; Most complications were low grade (75% and 83%)
Followup was available in 87 dogs, at a median of 1062 days.
Hernia recurrence was not reported.
The deaths of 9 dogs (five ST, four CT) could be attributed to PPDH
Long median survival times were observed
in both the ST and CT groups (8.2 and 5 years).
Spillebeen, Vet Surg 2017
What was found in regards to treatment of septic peritonitis?
Negative pressure abdominal drainage vs. passive
Overall survival was 81%.
Tx costs, Ax and operating time, drainage time, survival, and postop complications were similar between techniques.
Loss of total plasma protein and decreased inflammation-related factors in abdominal fluid at time of closure were noted in all patients.
Neutrophilic inflammation was greater in abdominal wall samples after NPAD.
POAD patients showed discomfort during bandage changes and had frequent leakage of abdominal fluid outside of the bandage.
NPAD resulted in less abdominal fluid leakage, and evidence of superior healing on histological evaluation of abdominal tissues.
Hatch, JAVMA 2018
What was the incidence of chyloabdomen in cats and dogs? Differences?
Incidence was 2.0 cases/100,000 admissions for cats and 2.8 cases/100,000 admissions for dogs.
Mean age at dx of chyloabdomen in cats was 11.3 years, compared with 6.9 years in dogs.
The most common c/s in dogs and cats combined were lethargy (39/51 [76%]) and anorexia (37/51 [73%]), but fewer (23/53 [43%]) had abdominal distention.
Chylothorax was a common comorbidity (25/53 [47%]), with malignant neoplasia being the most common underlying diagnosis (24/53 [45%]).
MST from diagnosis of chyloabdomen was 31 days overall (25 d for cats; 73 d for dogs), 8 days for patients with malignant neoplasia (carcinoma), and 73 days for patients without neoplasia.
Marshall, JVECC 2019
What was found in this septic peritonitis study?
The likelihood of an aerobic organism to have multidrug resistance post-lavage was a third of that pre-lavage
-39 of 40 dogs (97.5%) received appropriate empiric antimicrobial therapy based on pre- and post-lavage culture results, of which 5 (12.8%) did not survive to discharge.
Most frequent isolates detected included Escherichia coli, Clostridium perfringens, and Enterococcus faecalis.
The same organism based on species was isolated in pre- and post-lavage cultures in 32 dogs, accounting for
59 anaerobic and aerobic isolates. There was a new bacterial isolate detected in 20 dogs, accounting
for 46 isolates and an overall total decrease of 14 isolates between pre- and post-lavage culture
-Overall survival rates (87.5%) were higher than previously reported in the literature for septic peritonitis (20-85%)
Scotti, JVECC 2019
-What was found in cats with septic peritonitis (SP)?
58 survived to discharge (69.9%)
The most common etiology was secondary SP due to GI perforation (49.4%), followed by primary SP (22.3%).
Mean blood glucose concentration was significantly different between survivors and nonsurvivors
Cats that received appropriate empirical antibiotic
therapy were 4.4 times more likely to survive than cats that did not receive appropriate antibiotics
Davis
Preop septic peritonitis and anastomotic technique on dehiscence of enterotomy
VetSurg 2018
Dehiscence rate 11%
~w/o septic peritonitis 7%
~w/ septic peritonitis 21%
In septic peritonitis dehiscence
~stapled 8%
~Hand-sewn 29%
Risk factors for dehiscence
~septic peritonitis
~Hand‐sewn
Rodriguez
Feline Ventral abdominal wall
VetSurg 2018
Post umbilical region is biomechanically weak
Load to failure
Males > Female
Failure:
tearing of suture through tissues
Cudney
Diagnostic utility of AUS for hemoabdomen- nontraumatic
JAVMA 2021
Difference in AUS & Sx/Necropsy 54%
Sensitivity of AUS
~Spleen 87%
~Liver 37%
~Mesentery 31%
0 of 6 dogs with peritoneal diffuse nodular metastasis had lesions detected by AUS.
Hatch
Incidence of chyloabdomen
JAVMA 2018
MST 31d
~w/ neoplasia 8d
~w/o neoplasia 73d
Fink
Risk factors for recurrent 2ndary septic peritonitis
JVECC 2020
10% developed recurrent 2ndary septic peritonitis ~lower alb prior to 1st surgery ~higher PCV ~GI origin additional risk in GI origin ~w/ GI FB
Relaporatomy survival 43%
Scotti
Prognostic in Cats with septic peritonitis
JVECC 2019
Survival to discharge 70%
Causes
~GI perforation 50%
~Primary septic peritonitis 22%
Appropriate abs 4.4 x more likely to survive
Higher BG = poorer prognosis
(126 vs 164)
