Lecture 4: Clinical Correlations

What can you see from the left side?

liver, stomach, spleen, LVC, LDC, descending colon, jejunum

What are clinical signs of a colic?

depression, sweating, increased HR, diarrhea

What types of stomach-related diseases can cause colic?

gastric ulcers, impaction, dilation/rupture

What types of small intestine-related diseases can cause colic?

ascarid impaction, adhesions, intussuception, hernia, etc.

What types of large intestine-related diseases can cause colic?

impaction, displacement, colitis, etc.

Do most stomach ulcers show symptoms?

no until they are very serious

What is primary gastric impaction and rupture?

delayed gastric emptying

What is secondary gastric impaction?

intestinal obstruction

What is fibrous adhesion of the small intestine?

jejuno-jejunal anastomosis between adjacent loop of jejunum

What can parascaris equorum cause?

impaction in SI

What is the impaction of the ileon?

impaction of ileum with ingesta and distension of SI

What can anoplocephala perfoliata cause?

impaction of ileon

What is intussussception of small intestine?

invaginated of segment into more distal segment

What are types of intestinal intussussceptions?

jejuno-jejunal, ileal-ileal, ileocecal

Does intussussception frequently cause colics?

no

What is jejunum strangulation?

pedunculated lipomas that suspend in the mesentery and warp around segment of intestine interfering with blood supply and occludes intestinal lumen

What is internal incarceration associated with colic in the horse?

epiploic foramen entrapment

What are the borders of the epiploic foramen?

caudate lobe of liver, portal vein, caudal vena cava

What portions commonly get entrapped in epiploic foramen?

distal jejunum and ileum

What causes impaction of LI?

dry feed or foreign bodies

What are common impaction sites of LI?

pelvic flexure, RDC junction with the transverse colon, base and body of cecum

What are enteroliths or bezoars?

concretions of magnesium ammonimu phosphate crystals that form around nidus

Where are common enteroliths sites?

junction of right dorsal and transverse

What conditions require surgery using the ventral midline approach?

strangulation of SI, incarceration in epiploic foramen, intussusception, impaction in LI, etc.

What can you palpate rectally in horses?

small colon, LDC, LVC, pelvic flexure, cecum, ileum, jejunum, bladder, uterus, uterine horns, ovary, pelvic urethra, prostate vaginal ring

What disorders require invasice procedures in the abdominal cavity?

abomasal displacement, volulus, intussusception, bloat, dystocia, etc.

What are things to note or think about in a laparotomy in the paralumbar fossa?

standing animal, minimal intra-abdominal pressure, quick and easy, access to different organs, sedation not required

What are the borders of the paralumbar fossa?

cranial: last rib

dorsal: lateral border of spinal muscles

caudoventral: tuber coxae

Flank vs paralumbar fossa?

flank is the area on the animal that includes the paralumbar fossa (it is a part on the flank but doesn't make up the whole flank)

What nerve is T13? L1? L2?

intercostal nerve, iliohypogastric, iliolingual

What 3 nerves must be blocked to desensitize the paralumbar fossa?

T13, L1, L2

What is inverted L?

subcutaneous injection of anesthetic cranial and dorsal to site of incision

What is paravertebral?

anesthetic deposited at the cranial tips of the lumbar transverse processes to block T13, L1, L2

What is epidural?

anesthetic deposited in epidural space of vertebral canal through interarcuate space

What are structures incised during laparotomy in paralumbar fossa?

1. skin

2. superficial fascia

3. deep fascia

4. external abdominal oblique

5. internal abdominal oblique

6. transversus abdominis

7. retroperitoneal fat

8. parietal peritoneum

What is the grid technique?

Gridding technique is following the muscle fibers of the internal and external abdominal obliques with your incision rather than a straight vertical incision

What is the right flank used for in paralumbar fossa surgeries?

exploratory laps, correction of abomasal displacement, intussusception, intestinal phytobezoar

What is the left flank used for in paralumbar fossa surgeries?

c-sections, rumenotomy, rumenostomy

What are different displacements of abomasum?

LDA (left displacement abomasum), RDA (right displacement abomasum), AV (abomasum volvulus)

What is the most common displacements of abosmasum?

LDA

What percentage of displaced abomasums occurs within 1 month of partuition?

80%

What happens in right displacement of abomasums?

rotation of its mesenteric axis leading to volvulus, rich in gas and liquid leading to circulatory impairment and strangulating obstruction (counter clockwise direction)

How do you maintain abomasum in its place after displacement?

abomasopexy or omentopexy

When is exploratory laparotomy done?

when there is no specific diagnosis, but it can be through left or right paralumbar fossa

What interventions are performed in left paralumbar fossa?

1. rumenocentesis (bloat emergency)

2. rumenotomy (bloat, ruminal impaction, ingestion of toxins)

What are two clinical tests for abdominal pain?

withers pinch scoot test and grunt test

What is hardware disease?

Caused by the ingestion of metal objects which lodge in the reticulum, penetrate, and cause a local peritonitis.