Sx Diseases of the Stomach Objectives Flashcards

1
Q

What are the treatment options for gastric foreign bodies? What criteria would you use for choosing each?

A
  • Stabilize first (fluids, gastroprotectants)
  • Specific tx (lead-chelation; zinc-transfusion)
  • Removal options:
    • Conservative
    • Endoscopy
    • Gastrotomy
    • Induce emesis (Apomorphine)

Criteria is based on HOW LARGE the FB is!

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2
Q

What are predisposing factors for gastric foreign body?

A

Younger animals and conditions that predispose for pica

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3
Q

What conditions predispose animals for pica?

A

Pancreatic Exocrine Insufficiency

Hepatic Encephalopathy

Iron Deficiency

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4
Q

What are clinical signs associated with gastric outflow obstruction?

A

signs that start at weaning:

intermittent vomiting exacerbated by diet modifications and increases with solid food diets

normal to decreased BCS

abdominal distension but NO PAIN!

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5
Q

What are causes of gastric outflow obstruction and how can you differentiate them?

A

Congenital or Acquired Pyloric Stenosis

  • Congenital: YOUNG patients
    • Boston Terriers
    • Only affects pylorus- hypertrophy of circular muscles
    • Signs starting at weaning
  • Acquired: Middle-aged to older MALE patients
    • Small breeds- Lhasa Apso, Shih Tzu
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6
Q

Describe the blood supply to the stomach.

A

R&L gastric artery supplies the lesser curvature

R&L gastroepiploic artery supplies the greater curvature

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7
Q

What supplies the lesser curvature of the stomach?

A

R&L gastric artery

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8
Q

What supplies the greater curvature of the stomach?

A

R&L Gastroepiploic arteries

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9
Q

What is the etiology of congenital pyloric stenosis?

A

Maybe excess gastrin

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10
Q

What is the etiology of acquired pyloric stenosis?

(gastric outflow obstruction)

A

Unknown for sure, but maybe:

Gastrin secretion

Increased stress

Drugs

Trauma

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11
Q

What is the difference in regards to cats vs. dogs in

congenital and acquired pyloric stenosis?

A

RARE in cats!

Siamese cats rarely can have congenital pyloric stenosis

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12
Q

Which digestive hormone has been implicated in

the etiology of congenital and acquired pyloric stenosis

(gastric outflow obstruction)?

A

GASTRIN!

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13
Q

What diagnostic modality can be used to

differentiate congenital and pyloric stenosis and describe details?

A

Ultrasound

Can differentiate layers and determine stage

Normals= Muscularis < 4mm; Pyloric Wall < 9mm

Remember: Congenital = muscular hypertrophy; Acquired = muscular AND mucosal hypertrophy

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14
Q

What is the difference between congenital and acquired

pyloric stenosis in regards to tissues affected?

A

Congenital = muscular hypertrophy;

Acquired = muscular AND mucosal hypertrophy

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15
Q

What might you see on a radiograph in a case

of gastric outflow obstruction (pyloric stenosis)?

A

Beak/APPLE CORE sign

with contrast at later of the pylorus

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16
Q

What surgical techniques are used to correct

congenital pyloric stenosis?

A

Fredet-Ramstedt Pyloromyotomy (MILD cases)

or

Heineke-Mikulicz Pyloroplasty (Transverse) (SEVERE cases)

17
Q

What surgical techniques are used to correct

acquired pyloric stenosis?

A

Pyloroplasty (Transverse) - Grade 1

YU Pyloroplasty - Grade 2

Bilroth 1 - Grade 3

18
Q

Describe the pathological classification system

for acquired pyloric stenosis

A

Grade 1: Muscular hypertrophy

Grade 2: Muscular AND Mucosal hypertrophy

Grade 3: ALL layers- mucosal hyperplasia + muscular and submucosal inflammation

19
Q

Which pathological grade of acquired pyloric stenosis

is MOST common and how is it treated surgically?

A

Grade 2: YU Pyloroplasty

20
Q

What is the signalment for gastric adenocarcinoma?

A

Male, dogs, 7 - 10 years old

Rough collie, staffy terrier, and belgian shepherd

21
Q

What is the signalment for gastric leiomyoma?

A

OLDDDD patients > 15 y/o

22
Q

What is the signalment for gastric leiomyosarcoma?

A

Middle aged (7 years)- younger than adenocarcinoma

23
Q
A