Rectal Prolapse in Veterinary Medicine
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Questions and Answers

What is a significant health risk associated with untreated rectal prolapse?

  • Constipation
  • Weight loss
  • Dehydration
  • Necrosis (correct)
  • Rectal prolapse occurs most commonly in young pigs due to diarrhea or weak supporting tissues.

    True (A)

    What is the primary function of the rectum?

    Storage site for feces until defecation

    In rectal prolapse, the rectum can evert from partial to __________ prolapse.

    <p>complete</p> Signup and view all the answers

    Match the animal with the typical age range affected by rectal prolapse:

    <p>Cattle = 6 months to 2 years Pigs = Common at any age Small ruminants = Similar to adult cattle Ewe = Any age and sex can be affected</p> Signup and view all the answers

    Which part of the gastrointestinal tract is located retroperitoneally in the context of rectal prolapse?

    <p>Rectum (D)</p> Signup and view all the answers

    The length of the prolapsed tissue is unrelated to prognosis and treatment options.

    <p>False (B)</p> Signup and view all the answers

    What type of structure controls the expulsion of feces?

    <p>Anal sphincter</p> Signup and view all the answers

    What is the primary goal of submucosal resection in the context of a prolapse?

    <p>To salvage healthy underlying tissue while removing necrotic or traumatized mucosa (D)</p> Signup and view all the answers

    Amputation of the rectum should be considered in cases of minor tissue trauma.

    <p>False (B)</p> Signup and view all the answers

    What technique is used when the prolapsed mucosa is healthy but the mucosa is necrotic?

    <p>Submucosal resection</p> Signup and view all the answers

    The purse-string suture is usually left in place for _____ days.

    <p>5 to 10</p> Signup and view all the answers

    Match the following procedures with their correct descriptions:

    <p>Submucosal resection = Removal of necrotic mucosa while preserving underlying tissue Purse-string suture = Technique to secure the prolapsed tissue Prolapse repositioning = Returning the prolapsed tissue to its normal position Amputation = Removal of the rectum due to severe tissue damage</p> Signup and view all the answers

    Which circumstance would not require more aggressive treatment of a prolapse?

    <p>Viable mucosa with no laceration (A)</p> Signup and view all the answers

    Gentle pressure may be applied to reposition the prolapse.

    <p>True (A)</p> Signup and view all the answers

    What instrument is mentioned for use during the initial steps of submucosal resection?

    <p>Flexible tubing</p> Signup and view all the answers

    What is typically included in the post-operative care for rectal prolapse?

    <p>Strict dietary rest followed by gradually changing to normal food (D)</p> Signup and view all the answers

    Antibiotics are not necessary in post-operative care following rectal prolapse surgery.

    <p>False (B)</p> Signup and view all the answers

    What is a common complication that may arise after rectal prolapse surgery?

    <p>Stricture of the rectum</p> Signup and view all the answers

    The use of __________ can help ease defecation in post-operative care.

    <p>laxatives</p> Signup and view all the answers

    Match the following post-operative care elements with their purposes:

    <p>Dietary rest = Prepare the digestive system for normal function Antibiotics = Prevent infection Anti-inflammatories = Reduce swelling and pain Lidocaine infusion = Control straining during recovery</p> Signup and view all the answers

    What rare occurrence might happen due to failure of the suture line?

    <p>Catastrophic breakdown of the closure (A)</p> Signup and view all the answers

    Necrosis can occur if the blood supply to the prolapsed tissue is compromised.

    <p>True (A)</p> Signup and view all the answers

    What is the goal of retrograde hydropulsion?

    <p>To maximize urethral dilation (A)</p> Signup and view all the answers

    What should be done if straining continues after rectal prolapse surgery?

    <p>Epidural or Lidocaine infusion</p> Signup and view all the answers

    The Pezzar catheter should be secured to the body wall after placement.

    <p>True (A)</p> Signup and view all the answers

    What is the duration for antimicrobial treatment post-surgery?

    <p>7-14 days</p> Signup and view all the answers

    The technique used to close the bladder after surgery is a two-layer _______ suture.

    <p>inverting 3-0 absorbable</p> Signup and view all the answers

    Match the complications with their type:

    <p>Hemorrhage = Immediate Complication Recurrent urolithiasis = Long-Term Complication Bladder rupture = Immediate Complication Chronic cystitis = Long-Term Complication</p> Signup and view all the answers

    Which medication is commonly used for pain management after surgery?

    <p>Flunixin meglumine (D)</p> Signup and view all the answers

    It is acceptable to remove the tube after 5 days if the patient is urinating.

    <p>False (B)</p> Signup and view all the answers

    What should be done if dripping from the tube stops?

    <p>Check for blockage due to stone or blood clot</p> Signup and view all the answers

    What type of organism causes Thelaziasis?

    <p>Nematodes (D)</p> Signup and view all the answers

    Thelazia spp. are primarily transmitted by biting flies.

    <p>False (B)</p> Signup and view all the answers

    Name one species of Thelazia that affects cattle.

    <p>Thelazia gulosa</p> Signup and view all the answers

    The face fly, known scientifically as _____, serves as the intermediate host for Thelazia nematodes.

    <p>Musca automnalis</p> Signup and view all the answers

    Match the Thelazia species with their descriptions:

    <p>Thelazia rhodesii = Small, thin, yellowish-white worms 1.0–2.0 cm long. Thelazia gulosa = Milky-white worms with thin transverse cuticular striations. Thelazia spp. = Nematodes causing eye infections in cattle. Face flies = Intermediate hosts transmitting Thelazia to ruminants.</p> Signup and view all the answers

    What is the prepatent period for Thelazia species?

    <p>20–25 days (C)</p> Signup and view all the answers

    Male Thelazia worms have fewer pairs of pre-cloacal papillae than females.

    <p>True (A)</p> Signup and view all the answers

    What are the two features of Thelazia gulosa mentioned in the document?

    <p>Deep cup-shaped buccal cavity; thin transverse cuticular striations.</p> Signup and view all the answers

    What is the primary goal of avoiding the rectum during the surgical procedure?

    <p>To avoid damage to surrounding tissues (D)</p> Signup and view all the answers

    The internal iliac artery runs vertically across the pelvis.

    <p>False (B)</p> Signup and view all the answers

    What type of anesthesia is administered during the procedure?

    <p>Local anesthesia (epidural, pudendal, or line block)</p> Signup and view all the answers

    The ______________ technique involves a needle being inserted vaginally to create a horizontal mattress suture.

    <p>Buhner Needle</p> Signup and view all the answers

    Match the following terms with their definitions:

    <p>Internal iliac artery = Runs horizontally across the pelvis Pexy = Surgical fixation Buhner needle = Used to create sutures vaginally Rectal palpation = To ensure no suture has entered the rectum</p> Signup and view all the answers

    What is a possible complication of the Minchev pexy procedure?

    <p>Recurrence of prolapse (C)</p> Signup and view all the answers

    Postoperative care involves leaving sutures in place until parturition or at least three weeks for non-pregnant animals.

    <p>True (A)</p> Signup and view all the answers

    What should be done if the sutures enter the rectum?

    <p>They should be removed.</p> Signup and view all the answers

    Flashcards

    Urethral Hydropulsion

    A surgical procedure to remove a stone from the urethra by using a catheter and saline solution to push it out.

    Retrograde Hydropulsion

    A technique used in urethral hydropulsion where an assistant blocks the opening at the tip of the urethra and the surgeon blocks the beginning of the urethra, creating pressure to widen the urethra for easier stone removal.

    French Polypropylene Catheter

    A type of catheter used in urethral hydropulsion made of polypropylene, a type of plastic.

    Bladder Incision

    A procedure involving making an incision in the bladder to access and remove a stone.

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    Inverting 3-0 Absorbable Suture

    A type of suture used to close the bladder after an incision.

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    Pezzar Catheter Placement

    Inserting a Pezzar catheter through the bladder wall to drain urine after surgery.

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    Antimicrobials

    Medication typically prescribed after urethral surgery to prevent infection.

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    Removal of the Pezzar Catheter

    The removal of the Pezzar catheter after the surgery, typically 7-14 days later.

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    What are eyeworms?

    Thelazia nematodes, commonly known as eyeworms, are parasitic worms that infect the orbital cavities and surrounding tissues of various animals like cattle and horses.

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    How are eyeworms spread?

    Face flies act as intermediate hosts for eyeworms, transmitting the parasite to large ruminants.

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    What is Thelazia gulosa?

    Thelazia gulosa is a specific type of eyeworm characterized by its milky-white color, thin striations, and a deep cup-shaped mouth.

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    What is Thelazia rhodesii?

    Thelazia rhodesii is another type of eyeworm, distinguished by its small, thin, yellowish-white body and prominent striations at the head.

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    Where do adult eyeworms reside?

    Adult eyeworms live under the eyelids, nictitating membrane, nasolacrimal ducts, conjunctival sacs, and lacrimal gland ducts.

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    What is the prepatent period of Thelazia rhodesii?

    The prepatent period of Thelazia rhodesii, the time from infection to when the parasite becomes infectious, is 20-25 days.

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    What are the distinguishing features of male Thelazia gulosa?

    Male Thelazia gulosa have 8 to 33 pairs of pre-cloacal papillae and three pairs of post-cloacal papillae. They also have two asymmetric spicules, which are needle-like structures used for reproduction.

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    What are the distinguishing features of female Thelazia gulosa?

    Female Thelazia gulosa are 4.8-18.8 mm long and have a tapered tail.

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    What controls fecal expulsion?

    The expulsion of feces from the anus is controlled by the anal sphincter, a muscular structure that can contract or relax.

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    What is rectal prolapse?

    Rectal prolapse occurs when the rectum protrudes through the anus, ranging in severity from slight to complete.

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    How does prolapse length affect prognosis and treatment?

    The length of the prolapsed tissue, or how much of the rectum is sticking out, impacts the prognosis and treatment options. Longer prolapses are more challenging.

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    What does a rectal prolapse look like?

    Rectal prolapse can appear as a reddish, rosette-shaped structure extending from the anus.

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    Where is the rectum located?

    The rectum sits behind the small colon and is attached to the pelvic cavity. It narrows to a short canal, the anal canal.

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    Where is the blood supply to the rectum located?

    The rectum's blood supply is located on the dorsal (back) side, which is important for surgery.

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    Who is most likely to get rectal prolapse?

    Most common in cattle between 6 months to 2 years old, rectal prolapses can affect any breed, sex, or age group.

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    Why is rectal prolapse common in pigs?

    Diarrhea and weak support tissues in the pelvis can contribute to rectal prolapse in pigs.

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    Rectal Prolapse

    A condition where the rectum protrudes outside the anus, often caused by straining during defecation.

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    Suturing the Rectal Wall

    The process of stitching the rectal wall back into place.

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    Coated Polyglactin 910

    A type of suture material that dissolves over time and doesn't need to be removed.

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    Rectal Stricture

    A common complication after rectal prolapse surgery where the rectum narrows, making defecation difficult.

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    Necrosis

    A surgical technique where tissue is clamped and cut off to remove dead tissue.

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    Abscess

    A buildup of pus in the body, often caused by an infection.

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    Prognosis

    The likelihood of a successful outcome and recovery.

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    Predisposing condition

    A condition that increases the risk of something else happening, like rectal prolapse.

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    Minchev Pexy

    A surgical procedure that involves suturing the vaginal wall to the pelvic wall to prevent vaginal prolapse.

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    Buhner Needle Technique

    A technique used during Minchev Pexy that involves using a Buhner needle to pass suture material around the cervix and through a button.

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    Straight Needle Technique

    A technique used during Minchev Pexy that involves using a straight needle, thimble, and gauze to pass suture material around the cervix and through a button.

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    Internal iliac artery

    The internal iliac artery should be avoided during Minchev Pexy to prevent damage.

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    Double Pexy

    The Minchev pexy is performed on both sides of the vagina to provide additional support.

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    Sutures in place

    The suture materials should be left in place until parturition.

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    Infection

    Minchev pexy can be complicated by infection, but rarely leads to abscess formation.

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    Recurrence of prolapse

    One of the potential complications of Minchev pexy is recurrence of vaginal prolapse.

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    Submucosal Resection

    A surgical procedure to remove the affected mucosa while preserving the healthy underlying tissue in the treatment of rectal prolapse.

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    Flexible Tubing

    A flexible tube used to guide the prolapse back into its normal position in the treatment of rectal prolapse.

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    Cross-Pin Fixation

    A method used to secure the prolapse in its correct position after it has been reduced.

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    Submucosal Resection: A preferred technique for rectal prolapse

    The preferred technique for treating rectal prolapse when the prolapsed mucosa is damaged but the underlying tissue is healthy

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    Repositioning Rectal Prolapse

    The process of gently pushing the prolapse back into its normal anatomical position.

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    Lubrication in Rectal Prolapse

    Using lubrication to make the prolapse easier to reposition.

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    Purse-string Suture

    A suture used to secure the skin and fascia around the anus after rectal prolapse treatment.

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    Inserting Flexible Tubing

    The process of inserting a flexible tube into the lumen of the rectal prolapse.

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    Study Notes

    Cystotomy

    • Cystotomy is a surgical procedure involving the incision into the urinary bladder
    • It's performed for various therapeutic or diagnostic purposes, such as removing stones, tumors, or foreign bodies, repairing bladder tissues, and exploration.

    Relevant Anatomy

    • The urinary bladder is a muscular organ located in the pelvic cavity.
    • It has distinct layers: serosa (outermost), muscularis (detrusor muscle), submucosa (rich in blood vessels and elastic fibers), and mucosa (transitional epithelium)
    • Anatomical relationships: It's related to the umbilical ligament remnants, rectum in males or reproductive tract in females.
    • Blood supply: internal pudendal and umbilical arteries.
    • Innervation: sympathetic and parasympathetic nerves from the pelvic plexus.

    Indication

    • Mineral Composition (Foreign Bodies):
      • Struvite (Magnesium Ammonium Phosphate): most common in sheep and goats.
      • Calcium Carbonate: found mainly in horses.
      • Calcium Phosphate: common in cattle.
      • Silica: frequent in cattle and sheep on grain diets.
    • Risk Factors and Formation:
      • Dietary Factors: high grain diets, insufficient water intake, and mineral imbalances (Ca:P ratio).
    • Rupture Bladder:
      • Urethral Obstruction
      • Trauma (parturition, breeding, falls)
      • Severe Inflammation
      • Pressure necrosis from distension
    • Neoplasia Growth (rare):
      • Transitional cell carcinoma
      • Squamous cell carcinoma
      • Metastatic tumors

    Species Predisposition

    • Cattle: Males are more affected due to anatomical structure. Higher risk in feedlot animals; common in young, rapidly growing animals
    • Sheep and Goats: Males (particularly castrated) at highest risk. Early-castrated animals at increased risk.
    • Horses: No significant gender predisposition. More common in aged animals; performance horses at increased risk.

    Surgical Procedure

    • Bladder Exposure and Exploration: Incision through linea alba or paramedian adjacent to the prepuce; perform either paramedian or midline celiotomy; Identify bladder, Exteriorize the urinary bladder, Place two 3-0 stay sutures at dorsal bladder aspects, Incise bladder near trigone/pelvic urethra
    • Preoperative Positioning: Patient: dorsal recumbency, General anesthesia, Surgical site: caudal abdomen, adjacent to prepuce, Skin incision: 10-30 cm (size-dependent).
    • Stone Removal: Aspirate and lavage (trigone, bladder neck, & most proximal urethra), Remove adhered uroliths (soft-edged surgical spoon), Clear uroliths attached to bladder wall with fibrin or cellular debris, Flush bladder, Retrograde hydropulsion with 5-10 Fr catheter.
    • Urethral Obstruction Management: Attempt normograde urethral catheterization (8-10 French polypropylene catheter), Perform hydropulsion with saline, Exercise caution to avoid urethral rupture. If needed, perform retrograde hydropulsion (Assistant occludes distal urethra, Surgeon occludes proximal urethra), Goal: Maximize urethral dilation
    • Closure Techniques: Bladder: two-layer inverting 3-0 absorbable suture, Stay sutures: trim, secure, Body wall: Routine closure with subcutaneous Continuous 2-0 absorbable/Linea alba: Continuous 0 slowly absorbing, Skin: Nonabsorbable Ford interlocking/continuous
    • Catheter Management: Secure Pezzar to body wall, Align with preputial opening, Fingertrap knot to the Pezzar

    Post Treatment (medications)

    • Antimicrobials: Broad-spectrum coverage, typically 7-14 days.
    • Pain Management: NSAIDs (Flunixin meglumine, Phenylbutazone), Opioids (as needed).
    • Fluid Therapy: Maintenance requirements, Electrolyte monitoring, pH management.

    Complications

    • Immediate Complications (Surgical): Hemorrhage, Bladder rupture, Anaesthetic complications, Contamination.
    • Immediate Complications (Post-Operative): Urinary leakage, Infection, Ileus, Pain management issues.
    • Long-Term Complications (Medical): Recurrent urolithiasis, Chronic cystitis, Bladder dysfunction, Adhesion formation.
    • Long-Term Complications (Management): Incisional herniation, Persistent urinary issues, Behavioral changes, reduced performance

    References

    Note: Reference information included in the images are listed in the document, the citations from the image data have been omitted from this study note.

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    Description

    This quiz tests your knowledge on rectal prolapse, focusing on its causes, surgical interventions, and involved anatomy. Learn about the animals most affected and the management strategies for this condition. Perfect for veterinary students and professionals alike.

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