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27 Cards in this Set
- Front
- Back
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Coeliotomy |
Incision into abdominal cavity |
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Laparotomy |
Incision through muscle into abdomen |
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Acute abdomen |
Catastrophic abdominal pathology Shock, death, early surgical intervention |
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Anatomy of abdominal muscles |
Rectus abdominus
Internal rectus sheath and external rectus sheath have aponeurosis |
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Where do you only have to close external sheath and why? |
Cranially as this part is not as strong as caudal part |
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Which approaches are there? |
Ventral midline coeliotomy Flank laparotomy Paracostal laparotomy |
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Organ centred approach vs. exploratory coeliotomy? |
Organ-centred - Quicker, lower morbidity
Exploratory - better exposure, more likely to achieve goal, can evaluate whole abdomen, length doesn't affect healing time, xiphisternum to pubic brim |
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Where should you clip? |
Full abdominal surgery |
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Which muscles must be cut through in males? |
Preputial muscles and ligate vessels - epigastric artery and vein |
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How do you prevent tissue desiccation? |
Moistened swabs Saline lavage Minimise suction |
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Cranial quadrant |
Diaphragm Liver Gall bladder Stomach |
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Right gutter |
Mesoduodenal sling Right limb pancreas Kidney Adrenal Portal vein Vena cava Ureter Ovary
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Left gutter |
Mesocolonic sling Kidney Adrenal Ureter Ovary |
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Caudal quadrant |
Colon Reproductive tract Bladder Urethra Inguinal rings Prostate |
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Assessing intestines |
Palpate entire length
Assess peristalsis, colour, pulses
Mesenteric lymph nodes |
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Central abdomen |
Omentum Spleen Left limb of pancreas |
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Layer 1 of coeliotomy closure |
Close external rectus sheath as main holding layer Simple interrupted or continuous (7 throws start and finish) Monofilament, synthetic suture |
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Effects of incorrect closure? |
Incisional hernia Peritonitis Evisceration Death |
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Layer 2 |
Subcutaneous tissue - closes dead space and supports skin closure |
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Layer 3 |
Skin apposition |
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Primary generalised peritonitis |
Spontaneous No pre-existing abdominal disease e.g. FIP |
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Secondary generalised peritonitis |
Secondary to pre-existing abdominal pathology e.g. GIT rupture, urine leakage, penetrating trauma, bile leakage following trauma |
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Infectious |
Bacterial, from GI tract, often iatrogenic |
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Non-infectious |
Urine, bile, foreign body, pancreatitis |
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Clinical signs |
Abdominal distension, pain, fluid thrill, dullness, history of abdominal surgery or foreign body
Shock - pale, prolonged CRT, tachycardia, weak pulses
Sepsis - pyrexia, bounding pulses, toxic mucous membranes |
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Diagnosis |
Paracentesis and fluid analysis (empty bladder) - 4 quadrant tap and ultrasound guided tap
Radiography - loss of serosal detail, free abdominal gas
Ultrasound - turbid abdominal fluid, identification of underlying pathology |
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Treatment for generalised septic peritonitis |
Manage shock and treat sepsis
Address underlying pathology
Lavage abdomen
Place drains |
