SOFT TISSUE SX 8 Flashcards
What are the indications for colonic surgery?
- Colonic biopsy
- Neoplasia (tumors)
- Severe constipation (obstipation)
- (Rarely) Foreign body removal
Why is the colon vulnerable to ischaemic injury?
poor collateral blood supply due to one major vessel
Is feces in the colon gram - or gram +?
gram -
are perioperative antibiotics indicated in colonic sx?
yes
What are 3 types of common LI apthology?
megacolon
anal sac disease
rectal prolapse
What is megacolon?
Megacolon is characterized by large intestinal enlargement
hypomotility, leading to severe constipation and obstipation.
What are the two types of megacolon?
- Congenital
*acquired
What are the two types of congenital megacolon?
causes of each:
primary: neuro issue to the plexus (mesenteric & submucosal) in the colon
secondary: imperforate anus [poor colon and anus communication]
what is the msot common form of megacolon
feline idiopathic megacolon
What are the 3 causes of secondary megacolon?
- Functional (acquired dysautonomias, neurological injury)
- Intramural/mural (foreign bodies, neoplasia, strictures)
- Extramural (pelvic fractures, intrapelvic masses, pain, prostatic disease, perineal neoplasia)
What is the pathophysiology of megacolon?
The cycle involves:
* Retained feces becoming dry and impacted
* Formation of large, difficult-to-pass faecoliths
* Chronic stretching injury to the colonic wall
What are the diagnostic methods for megacolon?
- History of repeated episodes of constipation/obstipation
- Neurological exam
- Rectal exam (to identify obstructive problems)
- Radiographs (to detect issues like pelvic fractures)
Diagnostic imaging is crucial for identifying underlying causes.
is this a cat or a dog radiograph?
how do u know?
long, slender vertebrae
What are the components of medical management for megacolon?
- Rehydration and supportive care
- Colon evacuation via enemas and digital manipulation
- Dietary modification
- Laxatives
- Prokinetic agents
Colon diameter of over what size indicated megacolon?
colon diameter >1.5x length of L7
Why is a colotoym not reccomended for megaoclon?
colonic function is unlikely to return
Which species can handle a subtotal colectomy?
cats only
What is subtotal colectomy and its success in cats?
Subtotal colectomy involves removing 90-95% of the colon and is highly successful in cats.
HOWEVER, is highly complicated and should be referred
What are the complications of subtotal colectomy?
- Postoperative diarrhea (inevitable but manageable)
- Faecal incontinence (rare in long-term)
- Recurrence in the residual portion of the colon
-leakage due to improper anastamosis
What are the types of anal sac disease?
- Anal sacculitis (impaction and infection)
- Anal sac abscesses (+with rupture)
- Apocrine gland adenocarcinoma
which anal sac condition is more common in females?
apocrine gland adenocarcinoma
describe the steps to an anal sacculectomy
external incision
remove sac and ligate
cut out
What is the primary cause of rectal prolapse?
Rectal prolapse is usually secondary to conditions causing tenesmus (straining to defecate).
What are the management options for rectal prolapse?
- Manual reduction
- Surgical management (purse-string suture, colopexy, resection and anastomosis)
How can a rectal prolapse be differentiated from intrasussception?
by palpation with a thermometer: a gap between wall and intestines is a intussusception
What is colopexy?
Colopexy is a surgical procedure that adheres the colon to the abdominal wall to prevent prolapse.
True or False: Perioperative antibiotics are essential in colonic surgery due to high bacterial flora.
True
