Card Set Information

2012-10-05 16:54:15

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  1. What are some things that increase the severity of intestinal obstruction?
    complete, high or strangulated obstruction
  2. Should intestines be exteriorized or kept in the body cavity during sx?
    exteriorized and abdomen packed with moist lap sponges
  3. Should closing sutures be inverting, everting, or appositional? Holding layer?
    • appositional (simple interrupted/continuous)
    • submucosa engaged w/all sutures
  4. What suture is most appropriate? What needle?
    • small (3 or 4-0), monofilament, synthetic, absorbable or non
    • taper
  5. once procedure is complete, what should be done before closing abdomen?
    lavage the cavity
  6. In a clean-contaminated or contaminated procedure, what should be done with instruments before closing abdomen? What is protocol for antibiotic use?
    • replace contaminated instruments and gloves before close
    • use prophylactic Abs (30 min before or at induction)
  7. What is recommended antibiotics for upper and middle small intestine?
    1st generation cephalosporin (cephazolin)
  8. What is recommended antibiotics for lower small intestine and large intestine?
    2nd generation cephalosporin (cefoxitin)
  9. What antibiotic is used to cover anaerobes present in intestines?
  10. What is often the cause of intussusception in young dogs?
  11. What is the essential amino acid for enterocytes?
  12. What signalment is mesenteric torsion commonly associated with?
    adult German Shepherd dogs
  13. After 20 minutes of hypoxia, what is extent of injury in GIT? After 60 minutes?
    • 20- superficial villus injury
    • 60-destruction of villus
  14. After 4 hours of hypoxia, what is extent of injury to GIT? after 8 hours?
    • 4hr- transmucosal necrosis, turgid segment with whole blood collecting in lumen
    • 8hr-transmural infarction, becomes black, distended and elongated by 12hr
  15. Grossly, what kind of damage to GIT can be observed in teh first 1-3 hours of hypoxia?
    • wall edema and hemorrhage
    • mucosal sloughing
  16. When is gross necrosis evident in the hypoxic gut? Without treatment, when would death result? Due to what?
    • by 20hr
    • fatal in 3-4 days due to hypovolemia
  17. Gaseous distention develops within initial 12-36 hours after obstruction and is followed by what?
    loss of fluid into intestinal lumen
  18. How can the body attempt to naturally repair denuded intestines?
    omental migration/adherence
  19. What type of obstructions lead to alkalosis? Acidosis?
    • alkalosis: pyloric/proximal duodenal obstruction
    • acidosis: mid-duodenal to ileal
  20. an untreated obstructed patient can die of hypovolemia in 3-4 days. What is fluid loss due to?
    • vomiting
    • sequestration in intestinal lumen
    • edema in intestinal wall, esp. w/venous occlusion of intestine
  21. What is a strangulating obstruction? What does these cause?
    • simple obstruction plus occlusion of blood supply to intestine
    • -bacterial overgrowth/translocation--> increased bowel permeability --> perforation/escape of contents ==> PERITONITIS
  22. What are some causes of strangulating obstructions?
    adhesions (hair pin&rough handling), intussusception, mesenteric torsion, strangulated hernia, FB
  23. What are 2 radiographic signs of linear FB?
    • plication in cranial abdomen
    • teardrop gas bubbles in intestine
  24. Is the surgeon more concerned with linear FB lacerating mesenteric or antimesenteric border? What is indicated if perforation happens?
    • mesenteric
    • resection/anastomosis
  25. What is intussusceptum v. intussuscipiens?
    • intussusceptum is telescoped into segment of intestine (usu. the proximal segment)
    • intussuscipiens "receives" the section
  26. What signalment and CS lead you to consider intussusception?
    • puppies (w/parasites)
    • bloody diarrhea, vomiting/abdominal pain
    • often palpable
  27. Is intussusception associated with hyper or hypo-motility of the gut?
  28. What is a godet sign?
    finger impression stays = edema
  29. Venous occlusion in intussusception can progress to .___ and ____
    perforation and peritonitis
  30. Gentle traction should reduce an intussusception, but what should be done if it is not reducible or necrotic?
  31. How much of the GIT can be resected?
  32. What are 2 observations that indicate viability of tissue once intussusception reduced?
    good CRT and peristalsis
  33. Who is most commonly affected by mesenteric torsion?
    • adult male medium/large breed dogs
    • German Shepherd, pointers
  34. T or F: mesenteric torsion patients can evolve from clinically normal to dead within hours.
  35. What are some CS of mesenteric torsion?
    peracute/acute; pain, shock, mild abdominal enlargement, depression, recumbency; nausea, vomiting, hematochezia
  36. how do you diagnose mesenteric torsion?
    • radiographs show entire small intestine (not stomach) distended with gas
    • US, Sx, or necropsy
  37. What is Sx treatment for mesenteric torsion?
    untwist, reposition, allow for reperfusion, assess viability, resect devitalized, lavage (consider euthanasia; reperfusion injury issues)
  38. How high is mortality for mesenteric torsion? How much of intestines are usually non-viable by time of sx?
    • up to 100%
    • entire jejunum and ileum