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ACVS Phase II 2023 Case Based Only > Peritonitis > Flashcards

Peritonitis Flashcards

1
Q

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?

A

Hansen, JVECC, 2019:
75% survival rate
75% had a gastrointestinal source of septic peritonitis
50% complication rate
33% had G-tube-related complications

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2
Q

Rodriguez, Vet Surg 2018
What did this study find in regards to the biomechanical properties of the feline ventral abdominal wall?

A

-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

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3
Q

Rossanesse, JSAP 2019
What congenital condition may be predisposed in Cavalier King Charles Spaniels? And what did this study find?

A

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

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4
Q

Matiasovic, JSAP 2018
What was found with thoracic/abdominal wall impalement in 54 dogs?

CT sensitivity?

Surgeries performed?

Survival rate for thoracotomy?

Overall survival?

A

Impalement most common
Wood
Thoracic cavity

CT:
sensitivity 64%

Surgery:
Thoracotomy 56%
Celiotomy 20%
FB retrieved 37%

Survival rate for thoracotomy cases was 93%

Overall long-term survival was 90%

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5
Q

Morgan, Vet Surg 2020
What was found in this retrospective study of 128 dogs with PPDH diagnosed?

Survival to discharge for sx patients?

MST ST vs CT?

A

Surgically treated
-were younger
-sexually intact
-have C/S from PPDH
-more likely to have other congenital abnormalities

97% of ST dogs were discharged from hospitals.

MST
-ST 8.2 y
-CT 5 years

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6
Q

Spillebeen, Vet Surg 2017
Negative pressure drain vs. Passive abdominal drainage

What was found in regards to treatment of septic peritonitis?

A

Overall survival was 81%.

Neutrofilic inflammation in abdominal wall NPAD>POAD

POAD patients showed discomfort during bandage changes and had frequent leakage of abdominal fluid outside of the bandage.

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7
Q

Hatch, JAVMA 2018
Chyloabdomen in cats and dogs

Age of diagnosis?

Most common underlying diagnosis?

MST from diagnosis
-cat
-dog
-with neoplasia
-w/o neoplasia

A

Mean age at dx of chyloabdomen
-cats 11.3 years
-dogs 6.9 years

Most common underlying diagnosis carcinoma 45%

MST from diagnosis of chyloabdomen
-cat 25 d
-dog 73 d
-Neoplasia 8 days (carcinoma)
-w/o Neoplasia 73 days

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8
Q

Marshall, JVECC 2019
What was found in this septic peritonitis study?

A

Likelihood of multi-drug resistance post-lavage was a third of that pre-lavage

Most frequent isolates: Escherichia coli
Clostridium perfringens
Enterococcus faecalis

Overall survival rates (87.5%)

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9
Q

Scotti, JVECC 2019
-What was found in cats with septic peritonitis (SP)?

Survival to discharge?

Causes is septic peritonitis?

What was associated with survival?

A

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

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10
Q

Davis
Preop septic peritonitis and anastomotic technique on dehiscence of enterotomy
VetSurg 2018

A

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

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11
Q

Rodriguez
Feline Ventral abdominal wall
VetSurg 2018

A

Post umbilical region is biomechanically weak

Load to failure
Males > Female

Failure:
tearing of suture through tissues

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12
Q

Cudney
Diagnostic utility of AUS for hemoabdomen- nontraumatic
JAVMA 2021

A

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.

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13
Q

Hatch
Incidence of chyloabdomen
JAVMA 2018

MST?

A

MST 31d
~w/ neoplasia 8d
~w/o neoplasia 73d

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14
Q

Fink
Risk factors for recurrent 2ndary septic peritonitis
JVECC 2020

A 
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%

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15
Q

Scotti
Prognostic in Cats with septic peritonitis
JVECC 2019

A

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)

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16
Q

Gardner JVECC 2022

At what pressure is decompression recommended?

A

20 mm Hg

17
Q

Fleming, Vet Surg 2018
What’s the significance of spontaneous hemorrhage discussed in this paper?

A

Splenic hemorrhage was diagnosed in 43.2% of small dogs and 61.3% of large dogs.
Small dogs had lower prevalence of splenic hemorrhage and higher prevalence of hemorrhage from liver or from another location such as retroperitoneal mass, kidney, or adrenal vs large dogs.
Hemangiosarcoma was associated with splenic hemorrhage and occurred more frequently in large vs small dogs

18
Q

Anderson JSAP 2021

Overall survival rate in feline septic peritonitis?

What finding was associated with non survival?

Survival to what day post op was associated with improved likelihood for survival?

All patients that survived to what day PO survived to discharge?

A

Overall survival rate in feline septic peritonitis?
66%

What finding was associated with non-survival?
Intra-op hypotension

Survival to what day post op was associated with improved likelihood for survival?
1d

All patients that survived to what day PO survived to discharge?
6d

19
Q

Hatch et al JAVMA 2018 What differences were identified in dogs vs cats with chyloabdomen?

A
  1. Cats older at the time of diagnosis
  2. Cats more likely to have increased abdominal TP and cholesterol
  3. MST longer in dogs, but not statistically different
20
Q

What did Hatch et al JAVMA 2018 conclude about chyloabdomen in dogs and cats?

A

outcome depends on underlying cause (worse for neoplasia Chylothorax present in 47% of cases

21
Q

According to Davis et al VetSurg 2018 is preoperative septic peritonitis a risk factors for dehiscence following R and A?

A

yes

These patients 3.8 times more likely to dehisce

22
Q

Davis et al VetSurg 2018 Does type of enterostomy technique influence likelihood of dehisence with preoperative septic peritonitis?

A

Yes

Staples anastomosis less likely to dehisce in the presence of preoperative septic peritonitis

23
Q

Marshall et al JVECC 2019 What differences were identified between pre- and post-lavage bacterial cultures from dogs with septic peritonitis?

A

Positive culture - 92% pre, 87% post Antibacterial resistance - 57% pre, 67% post
Multi drug resistance - 33% pre, 14% post

24
Q

Fink et al JVECC 2020 What blood work values were associated with recurrence of septic peritonitis?

A

Low albumin prior to 1st surgery Increased PCV prior to 1st surgery

25
Q

Fink et al JVECC 2020 What risk factors were identified for development of recurrent septic peritonitis?

A
  1. Sepsis of GI origin, especially GIFB
  2. Hypoalbuminemia
  3. Increased PCV
26
Q

Scotti et al JVECC 2019

What factors were associated with survival for cats with septic peritonitis?

A

Blood glucose

Appropirate empirical antibiotic therapy

ACVS Phase II 2023 Case Based Only (22 decks)

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