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Small Animal Surgery > Stomach > Flashcards

Stomach Flashcards

1
Q

What conditions predispose to PICA?

A
  • pancreatic exocrine insufficiency
  • hepatic encephalopathy
  • iron deficiency
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2
Q

What are the common clinical signs associated with a gastric foreign body?

A
  • vomiting most common

- dehydration and lethargy

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3
Q

What is found on physical exam of a dog with a gastric FB?

A
  • distended abdomen
  • hematemesis
  • melena
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4
Q

What laboratory findings can be present in a dog with a gastric FB?

A
  • hemoconcentration or anemia
  • azotemia
  • alkalosis or acidosis
  • hypokalemia
  • hypochloremia
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5
Q

How can is a gastric FB diagnosed?

A
  • radiographs
  • ultrasound
  • endoscopy
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6
Q

What is the treatment/therapy for a gastric FB?

A
  • stabilize patient: fluids, gastroprotectants, analgesics
  • lead (chelation), zinc (tranfusion)
  • endoscopy or gastrotomy
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7
Q

Describe the gastrotomy procedure for removal of a FB

A
  • ventral midline incision from xyphoid to pubis
  • stab incision in center of vessels, then extend
  • remove FB
  • explore and lavage entire abdomen
  • closure
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8
Q

Which is the layer of strength in the stomach?

A

submucosa

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9
Q

When is a single layer closure of a gastrotomy indicated?

A
  • pyloric outflow tract
  • reduced gastric volume
  • thickened gastric wall
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10
Q

Which animals are predisposed to congenital pyloric stenosis?

A
  • brachycephalic breeds

- siamese cats

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11
Q

What is congenital pyloric stenosis?

A
  • gastric outflow obstruction

- hypertrophy of circular muscles

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12
Q

What are the clinical signs associated with congenital pyloric stenosis?

A
  • intermittent vomiting
  • abdominal distension without pain
  • normal to decreased body condition
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13
Q

How is congenital pyloric stenosis diagnosed?

A
  • radiographs
  • ultrasound
  • endoscopy
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14
Q

What is seen on radiograph of a congenital pyloric stenosis?

A
  • gastric distension
  • delayed gastric emptying
  • apple core sign with contrast
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15
Q

How is congenital pyloric stenosis treated?

A
  • Fredet-Ramstedt Pyloromyotomy

- Heinke-Mikulicz Pyloroplasty

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16
Q

Describe Fredet-Ramstedt Pyloromyotomy

A
  • no lumen exposure
  • isolate pylorus and make surgical incision through serosa and muscular layer
  • creates bulge which opens pylorus
  • leave to heal on its own
17
Q

Describe Heinke-Mikulicz Pyloroplasty

A
  • enters lumen of pylorus
  • full thickness incision
  • close in transverse orientation to help widen pyloric area
18
Q

Which animals are predisposed to acquired pyloric stenosis?

A

small breeds

middle-aged males

19
Q

What are the pathological classifications of acquired pyloric stenosis?

A

Grade 1 - muscular hypertrophy
Grade 2 - muscular and mucosal hypertrophy
Grade 3 - mucosal hyperplasia with muscular and submucosal inflammation

20
Q

What are the treatment options for acquired pyloric stenosis?

A
  • transverse pyloroplasty
  • Y-U pyloroplasty
  • Billroth 1: pylorectomy with gastroduodenostomy
21
Q

Describe Y-U Pyloroplasty

A
  • Y-shaped incision over pyloric antrum
  • create full thickness antral flap
  • pull flap down to base of the Y and suture it
22
Q

Describe pylorectomy with gastroduodenostomy

A

resecting entire affected pylorus and attaching proximal duodenum to stomach

23
Q

What are the clinical signs associate with gastric neoplasia?

A
  • vomiting
  • anorexia
  • regurgitation
  • melena
  • hematemesis
  • pain
  • weight loss
  • abdominal distension
24
Q

What are the lab findings associated with gastric neoplasia?

A
  • anemia
  • acidosis
  • hypochloremia
  • hypokalemia
25
Q

What is the most common gastric neoplasia in dogs?

A

gastric adenocarinoma

26
Q

What are the treatment options for gastric neoplasia?

A
  • gastrectomy
  • Billroth 1 or 2
  • chemotherapy
27
Q

What are the indications for a gastrectomy?

A
  • neoplasia
  • ischemic injury
  • ulcer
  • trauma
28
Q

Describe the Billroth 2 procedure

A
  • removal of entire pyloric antral area, significant portion of stomach, and part or proximal duodenum
  • side-to-side anastomosis of jejunum to stomach
29
Q

What are the complications of Billroth 2?

A
  • alkaline gastritis (secretions in blind sac mix with gastric secretions)
  • blind loop syndrome (food enters blind sac)
  • marginal ulceration (jejunum receiving pyloric secretions)
30
Q

Describe the Roux-en-Y Anastomosis procedure

A
  • resect significant portion of stomach up to proximal duodenum
  • resect duodenum by pancreatic ducts and anastomose on jejunum
  • stomach empties directly into duodenum
31
Q

Describe the features of a gastric leiomyosarcoma

A
  • smooth muscle origin
  • affinity for cardia
  • causes gastric uleration
32
Q

Describe the features of a gastric leiomyoma

A
  • benign, slow growing
  • no metastasis
  • may cause gastric outflow signs
33
Q

What is Pythiosis?

A

fungal disease that mimics gastric adenocarcinoma

- rapid growth rate an extensive

34
Q

How is pythiosis diagnosed?

A
  • endoscopy
  • ELISA/SNAP
  • histopathology
35
Q

What is seen on histopathology of pythiosis?

A

eosinophilic pyogranulomatous inflammation

36
Q

How is pythiosis treated?

A
  • resect as much tissue as possible
  • anti-fungals
  • immunotherapy
37
Q

What is the prognosis for pythiosis?

A

guarded to poor

38
Q

In which dogs do we more commonly see Pythiosis?

A

working/hunting dogs

Small Animal Surgery (26 decks)

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