Small Intestine Flashcards
Predisposing conditions of the small intestine for young horses
Incarcerations of the mesodiverticular bands
Volvulus
Predisposing conditions of the small intestine for old horses
SI incarceration in the epiploic foramen
Strangulation by a pendunculated lipoma
CS of SI obstructive dz
Non-specific signs
Gastric reflux during nasogastric intubation
Moderate to severe abdominal pain
Distended SI on rectal exam
Inguinal hernia: swollen scrotum
Single factor that horses should be considered for sx?
All horses having distended SI (few can be treated successfully)
Decisions when they should get SI surgery
Persistent abdominal pain
HR > 80 bpm
Abnormal rectal exam
Gastric reflux
Peritoneal fluid alterations
T/F: if there are problems with the SI and the horse has a fever you SHOULD operate
FALSE- never
Prerequisites for resection of the SI
Isolate affected intestine from incision
ID viable mesentery and intestine
Correction of intestinal displacement
Decompressed the proximal intestine
How is viability of the SI determined?
Grossly: color, contractions during handling , bowel wall thickness
Iv injections of fluorescein with UV light (vasc. integrity)
Doppler assessment of blood flow
How is distention of the SI measured?
Water manometer: 15 cm water or more indicate a small prognosis (susceptible to ileus, ↑ secretion, adhesions)
Hand suture of the SI
Apposition of the intestinal layers
Slight inversion
2-0 absorbable suture
Continuous suture with interruption
Surgical stapling (GIA)
GI anastomosis is used to create a blind stump at the prox. and dist. end of the intestine
Poor with thickened tissues
Surgical stapling (TA-90)
Thoraco-abdominal stapling
Better with thickened tissues
SI volvulus
Most frequently reported dz of SI
Young horses, linked to verminous arteritis
CS associated with SI volvulus
Acute severe pain with dehydration
Distention of the SI
Reflux fluid into the stomach
Shock and bowel degeneration
SI volvulus tx
SX correction: exteriorization of the entire SI and rotation of the intestine and mesentery around the abdominal incision
SI volvulus prognosis
> 50% of intestine involved: euthanasia
<50% alive in 1 year
Guarded to poor
Mesenteric incarcerations
When the SI is subject to incarceration in mesenteric rents of its own mesentery
Lesions: lipomas, mesodiverticular bands and meckel’s diverticulum
Rents of the SI
Found in dist. jejunum as remnants of the mesodiverticular band
Seen in mesoduodenum of pregnant mares