Surgery 6: SI Flashcards
What is the blood supply to the SI?
Cranial mesenteric
When is dehiscence most likely?
2-5 days
How long does it take to regain 80% of strength?
2 weeks
What should you do if in doubt about intestinal viability?
Remove
What four factors do you use to assess intestine viability?
Colour, thickness, blood vessels (thrombosis), peristalsis
What does peristalsis inducate?
Probably viable
In a foreign body, where is most of the bruising found
Proximal to the FB
Which pattern do you suture the intestine with?
Simple continuous (more watertight) starting in healthy tissue
Which material do you suture the intestine with?
3-0 or 4-0 PDS
In which situations is short-acting material too short?
Lymphoma or damaged tissue
What is the only holding layer in the intestines?
Submucosa - so need full thickness bites
What are the indications for enterectomy?
Ischaemic bowel, intuss, tumour
What margins do you need for a tumour?
3cm
What is the minimum amount of healthy tissue needed?
A few mm
How do you ligate the blood vessels for an enterectomy?
Double ligate and cut (one close to intestine, one further away)
Which suture pattern do you use for an enterectomy?
Full thickness apposition pattern
Why do you not suture an enterctomy all the way around?
Forms a purse string
How do you line up an enterectomy?
Put two sutures at the start
What do you do if there is a luminal size disparity?
Cut smaller side on diagonal or do a “fishmouth” (triangle of tissue)
What is the indication for “serosal patching”?
For previous dehiscence - stitch wall of another part of intestine over the site
What happens if you remove over 80% of the SI?
Small bowel syndrome - bacterial overgrowth and chronic diarrhoea
Where are linear FBs found in cats?
Tongue
Where are linear FBs found in dogs?
Pylorus
Where are the perforations in a linear foreign bosy?
Along mesenteric border
What can a distended SI be mistaken for on radiography?
Normal LI
When should you start to feed after a GA?
Until fully recovered
What should the starvation period be for LI surgery?
Long, with low residue diet.
Do you do an enema for LI surgery?
No - solid faeces easier
Do you give routine antibiotics for LI surgery?
Yes
Why is LI healing slower?
More collagenase, poor blood supply, more mechanical stress
How common is vomiting with LI issues?
Not
What are more likely LI symptoms?
Tenesmus, dyschezia, haematochezia, diarrhoea, constipation
Why is ultrasound less useful for the LI?
Gas artefacts
What approach do you use if doing caudal surgery on the LI?
Pelvic symphysiotomy or osteotomy
When is the only time you do a colotomy?
Biopsy
How much of the colon can you resect?
All
When might you resect the whole colon?
megacolon
How can you prevent incontinence following rectal resection?
Save the last 1-2cm if possible, avoid damaging the nerve supply
