Veterinary Medicine: Distended Abdomen Quiz

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Questions and Answers

Which condition is a contraindication for performing an abdominocentesis?

  • Severe dehydration
  • Normal organ size
  • Mild abdominal pain
  • Coagulopathy (correct)

What is the appropriate needle gauge for a small dog or cat during abdominocentesis?

  • 21G, 1''
  • 23G, ¾ '' (correct)
  • 20G, 1.5''
  • 25G, ½ ''

What type of fluid would appear clear and colorless on analysis?

  • Chyle
  • Transudate (correct)
  • Exudate (Septic)
  • Modified transudate

When should the abdomen not be drained during abdominocentesis?

<p>If respiratory compromise is present (B)</p> Signup and view all the answers

Which cause is associated with modified transudate that is yellow or blood-tinged?

<p>Cardiac tamponade (C)</p> Signup and view all the answers

What is the primary procedure performed following a diagnosis of ascites on ultrasonography?

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

Which of the following factors is NOT typically considered in the history taking for abdominal distension?

<p>Current medication (C)</p> Signup and view all the answers

Which sign is associated with cardiovascular examination in cases of abdominal distension?

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

What laboratory result may indicate the need for abdominocentesis if it is at 15 g/l or lower?

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

What diagnostic imaging technique is mentioned as being utilized for assessing abdominal distension?

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

What is the primary goal of surgery for GDV?

<p>To reposition and de-rotate the stomach (B)</p> Signup and view all the answers

Which method is commonly used to differentiate between gastric dilation and volvulus?

<p>Radiography (C)</p> Signup and view all the answers

What immediate step is important in the initial stabilization of a patient with GDV?

<p>Decompression of the stomach (A)</p> Signup and view all the answers

Why is serum lactate considered a useful marker in GDV cases?

<p>It serves as a marker for gastric necrosis (C)</p> Signup and view all the answers

What does acute abdominal distension typically indicate in regards to underlying conditions?

<p>It may be a symptom of various underlying diseases (A)</p> Signup and view all the answers

What characteristic radiographic finding is associated with gastric dilation and volvulus (GDV)?

<p>Air in the fundus ventrally and pylorus dorsally (C)</p> Signup and view all the answers

Which of the following is NOT a potential complication of gastric distension?

<p>Gastric ulcer formation (C)</p> Signup and view all the answers

What factor is a significant consideration before performing a liver biopsy?

<p>Coagulation profile (C)</p> Signup and view all the answers

In which situation would a percutaneous core biopsy NOT be appropriate?

<p>Deep abdominal inflammation (C)</p> Signup and view all the answers

What breed of dog is most commonly associated with gastric dilation and volvulus (GDV)?

<p>Giant and large breed dogs (C)</p> Signup and view all the answers

What is the primary symptom indicating the possibility of gastric dilation?

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

Which of the following conditions is often linked to gastric dilation complications?

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

Which aspect of gastric dilation affects respiration and oxygenation?

<p>Increased abdominal pressure (D)</p> Signup and view all the answers

Which of the following is a potential cause of abdominal distension due to true distension?

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

Which of these conditions is associated with gastric dilatation/volvulus syndrome?

<p>Dilation of the stomach (B)</p> Signup and view all the answers

What is a complication that may arise from diagnostic techniques related to abdominal distension?

<p>Misinterpretation of true distension (A)</p> Signup and view all the answers

Which diagnostic procedure is commonly performed to assess fluid accumulation in the abdominal cavity?

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

What is a true characteristic of ascites?

<p>Fluid accumulation in the abdominal cavity (A)</p> Signup and view all the answers

Which of the following can result from a rupture of the abdominal wall?

<p>Abdominal muscle rupture (D)</p> Signup and view all the answers

Which condition is least likely to cause abdominal distension?

<p>Dilation of the neck (C)</p> Signup and view all the answers

Which factor can lead to organomegaly contributing to abdominal distension?

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

Flashcards

Abdominal Distension

Increased size or swelling of the abdomen.

Abdominocentesis

A medical procedure involving the removal of fluid from the abdominal cavity.

Ascites

An excess buildup of fluid within the abdominal cavity.

Ultrasonography

A diagnostic test that uses sound waves to create images of the inside of the abdomen.

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Radiography

A diagnostic imaging technique using X-rays.

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Transudate

A type of fluid that is clear, colorless, and has a low protein content. It is often caused by liver failure, protein-losing enteropathy (PLE), or protein-losing nephropathy (PLN).

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Modified transudate

A type of fluid that is yellow or blood tinged, can be turbid, and has a higher protein content than transudate. It is often caused by portal hypertension, right-sided congestive heart failure (CHF), or cardiac tamponade.

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Sterile Exudate

A type of fluid that is turbid (cloudy) and has a high protein content. It is often caused by feline infectious peritonitis (FIP), pancreatitis, or neoplasia.

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Septic Exudate

A type of fluid that is turbid (cloudy) and can be blood stained. It is often caused by gastrointestinal (GIT) perforation, penetrating wound, or ruptured pyometra.

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Gastric Dilation (GD)

A condition where the stomach fills with air, causing dramatic distension.

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Gastric Dilation and Volvulus (GDV)

A condition where the stomach twists on its axis, often leading to a life-threatening situation.

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Increased Intragastric Pressure

An increase in pressure within the stomach due to air accumulation.

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Decreased Perfusion of Gastric Mucosa

Reduced blood supply to the stomach lining due to compressed blood vessels.

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Oesophageal Sphincter Occlusion

A condition where the esophagus valve is blocked, making it difficult for air to escape the stomach.

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Vena Cava Occlusion

A condition where the vena cava is blocked, leading to reduced blood flow back to the heart.

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Hypovolaemic Shock

A critical medical condition characterized by dangerously low blood pressure.

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Metabolic Acidosis

A type of acid-base imbalance caused by an increased level of lactic acid in the bloodstream.

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What is Gastric Dilatation and Volvulus (GDV)?

Gastric dilatation and volvulus (GDV) is a life-threatening condition in dogs where the stomach twists on itself, blocking the passage of food and gas.

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How do you diagnose GDV?

Radiographs are used to confirm GDV by visualizing the dilated and twisted stomach. It helps differentiate it from a simple stomach dilation.

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What is the first step in treating GDV?

Initial stabilization involves decompression of the stomach using a stomach tube or percutaneous gastrocentesis. This helps relieve pressure and reduce the risk of rupture.

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What is the surgical treatment for GDV?

Surgical intervention is necessary to reposition the stomach and prevent recurrence. A gastropexy procedure is performed to secure the stomach to the abdominal wall, preventing it from twisting again.

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Why is early intervention crucial for GDV?

GDV is a serious condition that requires immediate attention. Early diagnosis and intervention greatly improve the chances of survival.

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Gastric Dilatation Volvulus (GDV)

A condition where the stomach twists on itself, blocking the passage of food and gas, and potentially cutting off blood supply. This is a serious condition that can cause pain, vomiting, and shock.

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Bladder Obstruction

A condition where the bladder is unable to empty properly due to an obstruction or other problem. This can lead to a distended bladder and discomfort.

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Pneumoperitoneum

The buildup of gas in the abdomen, often leading to distension. It can be caused by various factors, including intestinal blockages, infections, and certain medical conditions.

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Organomegaly

The enlargement of an organ beyond its normal size. This can occur in various organs within the abdominal cavity, including the liver, spleen, and kidneys.

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Abdominal Wall Rupture

The rupture of the abdominal wall, including the abdominal muscles, tendons, or other structures, leading to a weakened abdominal wall and potential distension.

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Abdominal Neoplasia

An abnormal growth of tissue in the abdomen, which can lead to distension by compressing or displacing abdominal organs.

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Study Notes

Approach to the Distended Abdomen

  • Distended abdomen can be caused by gas, fluid or solid objects
  • It's a symptom of an underlying disease requiring diagnosis
  • Common diagnostic methods include radiography, ultrasonography, and abdominocentesis
  • Fluid analysis in ascites aids diagnosis
  • Gastric dilation volvulus (GDV) is a life-threatening condition requiring urgent intervention

Learning Objectives

  • Identify potential causes of distended abdomen in companion animals
  • Outline the diagnostic process for distended abdomen
  • Recognize limitations and complications of diagnostic techniques
  • Describe the abdominocentesis procedure
  • Identify signs and pathogenesis of gastric dilation/volvulus syndrome
  • Describe the therapeutic approach for gastric dilation/volvulus syndrome

Abdominal Distension: Causes

  • True Distension: Issues within the abdominal cavity
    • Pneumoperitoneum (air or gas in abdominal cavity)
    • Obesity
    • Neoplasia (tumors)
    • Ascites (fluid accumulation)
      • Transudate (clear fluid)
      • Exudate (cloudy fluid)
      • Chyle (milky fluid containing fat)
      • Blood
      • Urine
      • Bile
  • Apparent Distension: Issues outside the abdominal cavity
    • Rupture of the abdominal wall (muscle or tendon rupture)
    • Weakness of the abdominal wall (e.g., hyperadrenocorticism, diabetes mellitus)
  • Organomegaly: Enlarged organs
    • Bladder obstruction/neoplasia
    • Kidney hydronephrosis/neoplasia
    • Spleen neoplasia
    • Liver disease/drug-induced issues
    • Stomach dilation/volvulus, distension
    • Intestine dilation/volvulus, obstipation
    • Uterus (pregnancy, pyometra, neoplasia)

Approach to Diagnosis

  • Signalment: Species, breed, age, sex, body condition score
  • Cardiovascular: Jugular distension, mucous membrane color/pallor/jaundice, respiratory rate and effort
  • Abdominal Palpation: Palpation of individual organs, ballottement (assessing for fluid thrill), percussion (assessing for gas)
  • Laboratory Investigations:
    • Haematology (PCV, RBC, WBC)
    • Biochemistry (TP, albumin, ALT, ALP, bilirubin, creatinine, urea for liver, kidney, bladder)
    • Serum Albumin (<15g/L suggests ascites, >15g/L likely to aid with abdominocentesis)
  • Imaging:
    • Radiography (X-rays)
    • Ultrasonography (for visceral structures, fluid, organ size)
  • Abdominocentesis:
    • Procedure performed to obtain fluid samples (ascites) from abdomen
    • Useful after diagnosing ascites via imaging
    • Minimally invasive
    • Contraindicated in coagulopathy, severe organomegaly, marked distension

Fluid Analysis

  • Fluid Type & Appearance:
    • Transudate: Clear
    • Modified transudate: Yellow/blood-tinged
    • Exudate (Sterile): Turbid
    • Exudate (Septic): Turbid (maybe blood-tinged)
    • Bile: Yellow/brown/green
    • Blood: Red/sanguinous
    • Chyle: Cloudy white/cream
  • Possible Causes: Fluid analysis linked to specific potential causes as shown in the slide list (e.g., liver failure, portal hypertension)

Further Diagnostic Procedures

  • Fine needle aspirate (ultrasound-guided): Useful for liver, spleen, prostate, kidneys
  • Percutaneous core biopsy (for liver, renal cortex, superficial masses)
  • Trucut needle
  • Surgical biopsy (liver biopsies)
  • Coagulation profile
  • General anesthesia
  • Risk of hemorrhage if hypoalbuminemic – potential wound healing impairment

Gastric Dilation/Volvulus (GDV)

  • Aetiology:
    • Giant/large breed dogs
    • Familial history
    • Multifactorial (excessive exercise, overeating, water intake, aerophagia)
    • Stretching of gastrohepatic ligament (with age)
  • Pathogenesis:
    • Intragastric pressure increases
    • Small blood vessel compression leading to gastric necrosis
    • Oesophageal and vena cava compression and occlusion
    • Hypovolaemic shock and impaired diaphragmatic function
  • Clinical Signs:
    • Unproductive retching, salivation
    • Abdominal distension; respiratory distress; hypo perfusion, pallor, tachycardia, weakpulses; shock
  • Diagnosis: Signalment and clinical signs; radiography (to differentiate from simple dilation)
  • Initial Stabilization: Decompression (stomach tube, trocharization/percutaneous gastrocentesis); intravenous fluids(2cephalic catheters); analgesia (iv opioid); lab work (minimum database; serum; lactate, ECG for arrhythmias)
  • Surgery: Emergency laparotomy (positioning & de-rotation of stomach; gastric & splenic ischaemia assessment; prevention of recurrence - gastropexy)

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