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Veterinary Surgery > Small Animal GIT Surgery > Flashcards

Small Animal GIT Surgery Flashcards

1
Q

Describe the blood supply to the oesophagus

A

Segmental

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2
Q

What are the layers of the oesophageal wall?

A

Mucosa, submucosa, muscularis and adventitia. Only the thoracic oesophagus has serosa.

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3
Q

What factors predispose the oesophagus to dehiscence?

A

Segmental blood supply.
Constant motion - swallowing, neck motion, etc.
No omentum - less physical support.
The cervical oesophagus has no serosa - no fibrin seal.
Passage of ingesta / saliva.

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4
Q

What are the 3 classifications of oesophageal obstruction and give an example for each:

A
  1. Extramural - vascular ring anomalies
  2. Intramural - oesophageal neoplasia / stricture
  3. Intraluminal - foreign bodies
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5
Q

What are the 3 predilection sites of oesophageal foreign bodies?

A

Thoracic inlet, base of heart and cranial to the diaphragm.

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6
Q

How do you treat oesophageal foreign bodies?

A

Most can be retrieved with endoscopy (as long as they are not penetrating), otherwise you can push them into the stomach and perform a gastrotomy.

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7
Q

How should you close oesophageal incisions?

A

2 layer closure. Mucosa & submucosa - holding layer. Muscularis & adventitia.

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8
Q

Which layer of the intestines is the only layer with good suture holding capacity?

A

Submucosa.

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9
Q

Which part of the small intestines has a segmental blood supply?

A

The duodenum.

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10
Q

Describe an intussusception:

A

Invagination of one segment of the intestines into the adjacent segment.

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11
Q

How would you treat intussusception?

A

Attempt to reduce - milk the apex towards the neck, applying gentle traction to the intussusceptum. Possibly intestinal plication to prevent reoccurence.

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12
Q

When does intussusception typically occur in puppies kittens?

A

After a bout of enteritis / verminosis.

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13
Q

What drug can be used to treat post-op ileus?

A

Metoclopramide.

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14
Q

Name the salivary glands:

A

Parotid, mandibular, sublingual, zygomatic, buccal and molar.

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15
Q

What is a salivary mucocoele?

A

accumulation of saliva in tissue adjacent to a gland/duct.

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16
Q

How can you treat salivary mucocoeles?

A

Repeated drainage (not curative and can introduce infection), sialoadenectomy (make sure you remove it all!), intra-oral marsupialisation (for ranula).

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17
Q

Which part of the GIT does the cranial mesenteric artery supply?

A

Ascending colon, caecum and transverse colon.

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18
Q

What part of the GIT does the caudal mesenteric artery supply?

A

Descending colon and the cranial rectum.

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19
Q

What is supplied by the internal pudendal artery?

A

Middle and caudal rectum and anus.

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20
Q

Does the colon contain more anaerobes or aerobes?

A

Anaerobes (100:1)

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21
Q

What aerobes are typically found in the colon?

A

Staph, E. coli, proteus & klebsiella.

22
Q

What anaerobes are typically found in the colon?

A

Bacteroides, Lactobacilli, Clostridium and Fusobacterium

23
Q

Discuss colon healing:

A

Wound tensile strength is lower than in SI. Slow healing and relatively high likelyhood of dehiscense due to: high bacterial load, segmental blood supply, bulky/solid colonic material creating mechanical stress.

24
Q

How can you prepare an animal for colonic surgery?

A

Starve. Could do multiple enemas but liquid in the colon is more difficult to deal with intra-operatively than solids…

25
Q

What is important to remember when performing a colopexy?

A

Do not suture into the colon lumen!

26
Q

How do you treat anal strictures?

A

Anoplasty.

27
Q

What are the clinical signs of anal sac disease?

A

Tenesmus, scooting, licking / biting perineum.

28
Q

What do anal sac carcinomas secrete?

A

Parathyroid-like hormone - can cause dystrophic calcification of soft tissues and hypercalcaemic nephropathy.

29
Q

Describe a ‘true’ hernia ring:

A

A normal defect in the abdominal wall, has a complete hernial sac - includes most congenital hernias.

30
Q

Describe a ‘false’ hernia ring:

A

Not a normal defect in the abdominal wall, usually does not have a complete hernial sac - includes most acquired hernias.

31
Q

When can incisional hernias occur?

A

Any time from days to years after the incision.

32
Q

Describe a direct inguinal hernia:

A

Abdominal viscera passes through the inguinal ring into a pocket adjacent to the vaginal process.

33
Q

Describe an indirect inguinal hernia:

A

Abdominal viscera passes through the inguinal ring and enters the cavity of the vaginal process.

34
Q

Is an indirect or direct inguinal hernia more likely to cause strangulation?

A

An indirect hernia is more likely to cause strangulation due to the constriction of the vaginal process.

35
Q

Describe post-op nutrition for gastric surgery:

A

First 12hrs: only water (can add electrolytes).
Then mushy food every 4hrs.
Reintroduce normal diet over next 10 days.

36
Q

What happens if an animal is starved for more than 48hrs?

A

They enter a catabolic state. Bowel healing is retarded and enterocyte degeneration occurs.

37
Q

What features of the stomach aid gastric healing?

A

Excellent blood supply and low bacterial load in the starved patient.

38
Q

What can non-absorbable suture material do to the stomach?

A

Pre-dispose to gastric ulcers.

39
Q

What is the prognosis for pyloric antral hypertrophy v. pyloric neoplasia?

A

Pyloric antral hypertrophy: good prognosis.

Pyloric neoplasia: poor prognosis (metastasis, wound dehiscence, pancreatic and biliary obstruction).

40
Q

How would you treat pyloric antral hypertrophy?

A

Y-U pyloroplasty

41
Q

How would you treat pyloric neoplasia?

A 
Billroth 1 (pylorectomy and gastroduodenostomy) or
Billroth 2 (pylorectomy and gastrojejunostomy)
42
Q

How can you assess gastric wall viability?

A

Serosal colour, gastric wall perfusion, serosal vessel patency, gastric wall palpation.

43
Q

Name 4 gastropexy techniques:

A

Belt loop gastropexy, circumcostal, incisional, tube gastrotomy

44
Q

Why is a sialocele not considered a cyst?

A

Cysts are lined by epithelium. A sialocele is lined by granulation tissue.

45
Q

You are presented with a dog that has a midventral cervical mucocoele… how do you determine which side it is originating from?

A

Examine in dorsal recumbency - usually will fall to the affected side.

46
Q

What are treatment options for oesophageal stricture?

A

Bougienage.

Surgical resection and anastamosis.

47
Q

Describe the layers of the stomach wall and how you would close an incision?

A

Incised wall separates into 2 very distinct layers: Mucosa and submucosa. Muscle and serosa. Close the 2 layers separately using absorbable sutures in an inverting pattern.

48
Q

Which artery supplies the descending duodenum and pancreas?

A

Cranial pancreatic duodenal artery

49
Q

Where do linear foreign bodies commonly lodge?

A

Base of the tongue or pylorus

50
Q

What are the possible complications of total splenectomy?

A

Haemorrhage.
Gastric Wall Necrosis.
Temporary Anaemia.

51
Q

Are prophylactic antibiotics necessary prior to liver surgery?

A

YES! Portal blood carries GIT bacteria.

52
Q

Up to how much liver mass can be removed and still maintain function?

A

Up to 80%

Veterinary Surgery (7 decks)

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