Surgical management of colic:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1997
|
| Schriftenreihe: | [The veterinary clinics of North America / Equine practice]
13,2 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII, 441 S. Ill., graph. Darst. |
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| 245 | 1 | 0 | |a Surgical management of colic |c David E. Freeman ..., guest ed. |
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| 650 | 4 | |a Colic | |
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| adam_text | SURGICAL MANAGEMENT OF COLIC
CONTENTS
Preface xi
David E. Freeman
Epidemiology of Colic 191
Noah D. Cohen
Understanding the epidemiology of equine colic is directly rele¬
vant to the management of individual horses with colic. In this
article, the epidemiology of colic is reviewed with emphasis on
epidemiologic studies that have identified specific factors associ¬
ated with increased risk of colic and epidemiologic studies that
are designed to predict the need for surgery and prognosis in
horses with colic. Despite the magnitude of the problem of equine
colic, much remains to be learned about the epidemiology of
this disease.
Advances in Diagnostic Techniques for Horses with Colic 203
A. T. Fischer, Jr
Recent advances in the use of abdominal ultrasound, endoscopy,
laparoscopy, radiography, and peritoneal fluid analysis have con¬
tributed to the evaluation of horses with colic. Improved diagnos¬
tic capabilities allow earlier surgical intervention when necessary,
and this should improve survival rates and the economic aspects
of case management.
Adjunctive Methods in Equine Gastrointestinal Surgery 221
Linda Van Hoogmoed and Jack R. Snyder
The medical management of postoperative abdominal disorders
remains a diagnostic and therapeutic challenge for the equine
VETERINARY CLINICS OF NORTH AMERICA: EQUINE PRACTICE
VOLUME 13 • NUMBER 2 • AUGUST 1997 V
clinician. Recent advances in the development of techniques and
medications to offset or attenuate ischemia reperfusion injury,
endotoxemia, and ileus are encouraging and potentially will de¬
crease the incidence of additional complications.
Treatment of Impaction Colics 243
Nathaniel A. White II and Robin M. Dabareiner
Impactions have been reported in the stomach and all segments
of the intestine. Impactions predominately occur just oral to sites
of intestinal narrowing or active pacemakers. The most common
sites of impaction are in the ileum, the cecum, and the large
colon pelvic flexure. The treatment of gastrointestinal impactions
depends on the segment affected and the amount of bowel dam¬
age which has occurred from distension. Many impactions re¬
spond to appropriate administration of analgesics, cathartics, and
oral or intravenous fluids. The prognosis for impactions treated
medically is better than for those which require surgery.
Surgery of the Small Intestine 261
David E. Freeman
Although earlier reports describe a poor prognosis for small
intestinal surgery in the horse, there is growing evidence that the
short term survival rate can exceed 80%. In addition to advance¬
ments in surgery and aftercare, early referral contributes consid¬
erably to the improved prognosis. Surgical procedures that re¬
store anatomic and physiologic continuity to close to normal can
minimize postoperative complications. Jejunojejunostomy carries
a better prognosis than jejunocecostomy, probably because the
latter involves anastomosis between two intestinal segments with
dissimilar functions. Careful technique can reduce the prevalence
of complications, such as postoperative ileus and serosal adhe¬
sions.
Diseases and Surgery of the Cecum 303
Robin M. Dabareiner and Nathaniel A. White II
The cecum is an important site of water and electrolyte absorp¬
tion, as well as microbial digestion of soluble and insoluble carbo¬
hydrates. These functions of the cecum and ascending colon re¬
quire that ingesta be mixed constantly and retained long enough
to complete the digestion of cellulose. Parasites, changes in re¬
gional blood flow, diet, and various pharmacologic agents are
associated with alterations in normal cecal motility patterns.
Diseases and Surgery of the Large Colon 317
Janet K. Johnston and David E. Freeman
Displacements and intraluminal obstructions of the large colon
carry a good to excellent prognosis for long term recovery, and
vi CONTENTS
surgery for these diseases is rarely followed by short term or
long term complications. Entrapment of the large colon over the
renosplenic ligament is amenable to medical therapies so that
surgery can be avoided in many cases. However, preoperative
diagnosis of all nonstrangulating diseases of the large colon can
be difficult. Vascular diseases of the large colon, such as thrombo
embolic diseases and large colon volvulus, are more difficult to
treat and carry a poorer prognosis for survival.
Large Colon Resection 341
Faith E. Hughes and Donnie E. Slone, Jr
Strangulating large colon volvulus presents the surgeon with the
dilemma of determining the extent of compromise to the affected
tissue and the most appropriate surgical treatment of this tissue.
This decision is complicated because there is a significant volvu¬
lus recurrence rate. Large colon resection and anastomosis is the
most aggressive treatment option but prevents recurrence and
may provide an alternative to euthanasia for some horses.
Colopexy 351
Stephen R. Hance
Colopexy is a surgical procedure designed to create an adhesion
from the ventral colon to the body wall to prevent recurrence of
large colon volvulus or displacement, and is a useful technique
to prevent recurrence of this disease. Colopexies usually are re¬
served for broodmares, because this is the population of horses
that is most predisposed to recurrence of large colon volvulus.
Diseases and Surgery of the Small Colon 359
G. Barrie Edwards
Diseases of the small colon are numerous and they can affect
horses of any age. Diseases can be simple obstructions, nonstran¬
gulating obstructions, strangulating obstructions, and congenital
defects. American Miniature Horses appear prone to luminal
obstruction with impacted intestinal contents, and some ischemic
diseases are more common in postpartum mares. Enterotomy and
enterectomy have a high success rate in the small colon, provided
the affected portion can be exteriorized. The beginning and termi¬
nal portions of the small colon can be involved in many diseases
and are not readily accessible from standard abdominal ap¬
proaches. The prognosis is generally more favorable than has
been proposed.
Management of Rectal Tears 377
Aubrey N. Baird and David E. Freeman
Rectal tears have important medicolegal implications, and severe
tears have a poor prognosis. Prompt diagnosis, immediate appli
CONTENTS Vii
cation of first aid measures, early referral, use of appropriate
definitive treatments, and aggressive aftercare will improve the
prognosis. The grade of rectal injury will determine the definitive
treatment, but there are few guidelines to determine which treat¬
ment is best in each case. Bypass procedures, such as colostomy
and indwelling rectal liner, have their own advantages and disad¬
vantages, but can facilitate healing and prevent life threatening
complications if they are used with minimum delay. Suture of
the tear can be difficult, but should be attempted to hasten heal¬
ing and to prevent progression of the tear to a more severe injury.
Abdominal Surgery in Foals 393
James A. Orsini
Foals are good candidates for abdominal surgery because their
smaller size permits a more complete abdominal exploration and
frequently definitive procedures in many cases. The use of rectal
examination is replaced with alternative diagnostic modalities
such as barium contrast radiography and ultrasonography. With
the advancements in these technologies they can distinguish com¬
mon gastrointestinal lesions and, in most cases, provide sufficient
information to guide surgical intervention. The unique aspects of
diagnosis and surgical management of gastrointestinal disorders
of the foal are discussed.
Current Concepts in Management of Abdominal
Adhesions 415
Louise L. Southwood and Gary M. Baxter
Adhesions are an important complication after abdominal sur¬
gery in horses and foals, especially after small intestinal resection
and anastomosis. Prevention therapies used in horses have in¬
cluded nonsteroidal anti inflammatory drugs, antibiotics, heparin,
dimethyl sulfoxide, carboxymethylcellulose, and meticulous sur¬
gical technique; however, the ideal surgical technique and pre¬
vention therapy has not been determined. Further, treatment of
abdominal adhesions has a poor prognosis, emphasizing the need
for improvements in prevention methods.
Index 437
Subscription Information Inside back cover
Viii CONTENTS
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| title | Surgical management of colic |
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| title_full | Surgical management of colic David E. Freeman ..., guest ed. |
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