Podcast
Questions and Answers
Which type of laparotomy involves incisions through the rectus abdominis muscle?
Which type of laparotomy involves incisions through the rectus abdominis muscle?
In which type of laparotomy is the incision made in a lazy S shape?
In which type of laparotomy is the incision made in a lazy S shape?
Which anesthetic agent is typically used inruminants at a dose of 0.1mg/kg?
Which anesthetic agent is typically used inruminants at a dose of 0.1mg/kg?
What is the first step in the pre-operative technique prior to laparotomy?
What is the first step in the pre-operative technique prior to laparotomy?
Signup and view all the answers
What type of suture pattern is commonly used for suturing the peritoneum in small animals?
What type of suture pattern is commonly used for suturing the peritoneum in small animals?
Signup and view all the answers
What is the primary purpose of a laparotomy?
What is the primary purpose of a laparotomy?
Signup and view all the answers
Which area is suitable for performing a gastrotomy during a laparotomy?
Which area is suitable for performing a gastrotomy during a laparotomy?
Signup and view all the answers
During which phase is the surgical manipulation of the affected organ performed?
During which phase is the surgical manipulation of the affected organ performed?
Signup and view all the answers
Which anesthetic protocol is typically used for dogs and cats?
Which anesthetic protocol is typically used for dogs and cats?
Signup and view all the answers
Which of the following statements about laparotomy is false?
Which of the following statements about laparotomy is false?
Signup and view all the answers
What type of suture material is preferred for suturing subcutaneous tissues?
What type of suture material is preferred for suturing subcutaneous tissues?
Signup and view all the answers
What are the three main regions of the abdomen identified during laparotomy?
What are the three main regions of the abdomen identified during laparotomy?
Signup and view all the answers
What is a primary treatment option for wound dehiscence?
What is a primary treatment option for wound dehiscence?
Signup and view all the answers
In which area is a cystotomy typically performed in females?
In which area is a cystotomy typically performed in females?
Signup and view all the answers
What term refers to the incision made through the midline of the abdomen for laparotomy?
What term refers to the incision made through the midline of the abdomen for laparotomy?
Signup and view all the answers
Which of the following causes can lead to wound dehiscence?
Which of the following causes can lead to wound dehiscence?
Signup and view all the answers
What type of surgical procedure is indicated by nephrectomy?
What type of surgical procedure is indicated by nephrectomy?
Signup and view all the answers
What is a common characteristic of navel ill in newborn animals?
What is a common characteristic of navel ill in newborn animals?
Signup and view all the answers
Which surgical intervention can be performed in the right lumbar area during a laparotomy?
Which surgical intervention can be performed in the right lumbar area during a laparotomy?
Signup and view all the answers
Which bacteria are commonly associated with infections leading to joint ill in animals?
Which bacteria are commonly associated with infections leading to joint ill in animals?
Signup and view all the answers
What is the primary treatment for a post-operative seroma?
What is the primary treatment for a post-operative seroma?
Signup and view all the answers
What is a predisposing factor for umbilical infections in calves?
What is a predisposing factor for umbilical infections in calves?
Signup and view all the answers
What essential step is involved in the prevention of wound dehiscence?
What essential step is involved in the prevention of wound dehiscence?
Signup and view all the answers
Which of the following is NOT a cause of hemorrhage during or after surgery?
Which of the following is NOT a cause of hemorrhage during or after surgery?
Signup and view all the answers
What is a common consequence of improper suturing of the gut?
What is a common consequence of improper suturing of the gut?
Signup and view all the answers
Which age group is most commonly affected by joint ill due to umbilical infections?
Which age group is most commonly affected by joint ill due to umbilical infections?
Signup and view all the answers
What is typically used for post-operative wound dressing?
What is typically used for post-operative wound dressing?
Signup and view all the answers
What symptom is NOT typically associated with joint ill?
What symptom is NOT typically associated with joint ill?
Signup and view all the answers
What is an important preventative measure against infection post-surgery?
What is an important preventative measure against infection post-surgery?
Signup and view all the answers
What condition may occur due to weak scar tissue formation at the site of surgery?
What condition may occur due to weak scar tissue formation at the site of surgery?
Signup and view all the answers
Which treatment method is appropriate for incarceration of the bowel?
Which treatment method is appropriate for incarceration of the bowel?
Signup and view all the answers
What is the function of systemic antibiotics in post-operative care?
What is the function of systemic antibiotics in post-operative care?
Signup and view all the answers
Which joints are commonly affected by the condition described?
Which joints are commonly affected by the condition described?
Signup and view all the answers
What is a common clinical symptom observed in affected calves?
What is a common clinical symptom observed in affected calves?
Signup and view all the answers
What is the recommended method for diagnosing the condition?
What is the recommended method for diagnosing the condition?
Signup and view all the answers
What is the purpose of early treatment in this condition?
What is the purpose of early treatment in this condition?
Signup and view all the answers
Which antibiotic is mentioned as a treatment option?
Which antibiotic is mentioned as a treatment option?
Signup and view all the answers
Which of the following is a potential complication of the described condition?
Which of the following is a potential complication of the described condition?
Signup and view all the answers
What is an essential prevention measure for calves?
What is an essential prevention measure for calves?
Signup and view all the answers
What clinical sign may indicate that calves are experiencing significant distress?
What clinical sign may indicate that calves are experiencing significant distress?
Signup and view all the answers
Study Notes
Laparotomy
- Laparotomy is a surgical procedure to open the abdominal wall for good exposure of abdominal and/or pelvic organs.
- Lapar means abdomen; otomy means incision or opening.
- Laparotomy is the same as celiotomy.
Indications
- Exploration: Used to facilitate diagnosis (Open and See).
- Drainage: Used for fluid (as in cases of hepatic, cardiac, and renal dysfunction), urine (ruptured urinary bladder), and lavage (perforated abdominal wound).
- Gastrointestinal tract: Includes procedures like gastrotomy, enterotomy, rumenotomy, abomasopexy, intestinal resection, and anastomosis.
- Surgical interference in internal organs: Also includes excision of abdominal neoplasms, hepatic, splenic, and pancreatic surgeries.
- Urogenital tract procedures: Includes procedures like ovariectomy, ovarohysterectomy, caesarian section, cystotomy, nephrotomy, nephrectomy, prostatectomy, and cryptochidectomy. Applicable to herniorrhaphy.
- Experimental studies: Laparotomy can be used for this purpose as well.
Surgical Anatomy
- The abdomen is divided into three regions by two planes: one line between the margins of the last ribs, and another between the tuber coxae.
- Regions: Epigastric (Cranial third), Mesogastric (Middle third), and Hypogastric (Caudal third).
- Epigastric region: Xiphoid area (suitable for gastrotomy and splenectomy), left paracostal (hypochondric) area (suitable for splenectomy), right paracostal (hypochondric) area (suitable for hepatic surgeries).
- Mesogastric region: Umbilical area (suitable for ovariectomy), left lumbar area (suitable for surgeries of the left kidney), right lumbar area (suitable for surgeries of the right kidney).
- Hypogastric region: Prepubic area (suitable for cystotomy and hysterectomy in females), left inguinal (iliac) area (suitable for cystotomy in males), right inguinal (iliac) area (suitable for cystotomy in males).
- Surgical approaches: Ventral midline, cranial midline, middle midline, caudal midline, paramedian per-rectus (cranial paramedian, middle paramedian, caudal paramedian), paramedian lateral-rectus, paracostal, ventral midline-paracostal, paralumbar-paracostal (lazy S shape), inverted T (Mercedes shape).
Laparotomy Technique
-
Anesthesia:
- Equine: Inhalation anesthesia or deep narcosis with chloral hydrate (5g/50kg, 10% solution, IV), combined with local linear infiltration of lignocaine HCl (1mL/1cm).
- Ruminants: Xylazine HCl 2% (0.1mg/kg) with local linear infiltration of lignocaine HCl (1mL/1cm).
- Dogs and cats: General anesthesia with atropine sulphate (0.1mg/kg, SC), xylazine HCl 2% (1mg/kg, IM or IV), ketamine HCl 5% (5-10mg/kg in dogs, 20-33mg/kg in cats, IM or IV), and thiopental sodium (25mg/kg 2.5%, IV) for maintenance.
- Pre-operative technique: Fasting, clipping/shaving hair, washing with water and soap, drying in a sterile towel, disinfection with ethyl alcohol, painting with povidone iodine, and draping with sterile towels.
- Surgical technique: Skin incision, blunt dissection of subcutaneous tissues, raising abdominal muscles during peritoneal cavity opening by stab incision, widening with scissors while guarding viscera with fingers, exteriorization of the affected organ, wrapping affected organ with sterile gauze soaked in saline.
- Post-operative manipulation: Returning affected organ to its normal position, suturing peritoneum (interrupted or horizontal mattress pattern in large animals, continuous pattern in small animals), suturing subcutaneous tissues (simple continuous pattern), suturing skin (simple interrupted pattern).
- Post-operative care: Application of abdominal bandage, administration of systemic antibiotics, subcutaneous administration of anti-tetanic serum (equines 3000 IU, donkeys 1500 IU), daily dressing of wound with povidone iodine, removal of stitches (7-10 days).
Complications
-
Hemorrhage:
- Causes: Opening of abdominal wall (external bleeding), improper suturing of visceral organs (internal bleeding).
- Treatment: Ligation of bleeders, cauterization.
- Prevention: Proper suturing.
-
Post-operative seroma: Post-operative swelling due to inflammation.
- Treatment: Systemic antibiotics, good drainage (removal of lowest stitch), daily exercise.
-
Infection (either local or diffuse peritonitis):
- Causes: Improper surgical asepsis, dehiscence of visceral suture.
- Treatment: Intra-abdominal and systemic antibiotics, suturing of ruptured organs.
- Prevention: Proper aseptic surgery and correct suturing.
-
Fistulation:
- Cause: Improper suturing of gut leading to leakage, consequential subperitoneal abscess formation, and abscess opening to outside.
- Treatment: Re-operation for fistula excision.
- Prevention: Proper gut suturing.
-
Incisional hernia:
- Causes: Improper suturing of abdominal wall, weak scar tissue formation, increased intra-abdominal pressure after laparotomy.
- Treatment: Re-operation.
- Prevention: Proper suturing, avoiding increased intra-abdominal pressure.
-
Incarceration of the bowel:
- Cause: Improper suturing of peritoneum.
- Treatment: Re-operation.
- Prevention: Proper suturing of peritoneum.
-
Subcutaneous abdominal emphysema: Accumulation of air or gases under skin.
- Cause: Improper peritoneum suturing leading to air escaping into subcutaneous tissues.
- Treatment: Daily massage of emphysema.
- Prevention: Proper peritoneum suturing.
-
Wound dehiscence: Rupture of stitches, with or without prolapsed viscera.
- Causes: Improper suturing of abdominal wall, infection, damage by aggressive animals (licking, biting, scratching).
- Treatment: Re-operation, excision of necrosed tissues.
- Prevention: Proper suturing of abdominal wall, application of abdominal bandage, daily dressing with antiseptic solutions.
Umbilical Disorders
- Umbilical Infections
- Umbilical Hernia and Umbilical Infections
-
Umbilical Eventration
- is a congenital anomaly, characterized by prolapse of jejunum, frequently contained in a sac of peritoneum
- Patent Urachus (Persistent/Patent Urachus): A condition where the urachus, typically closing during fetal development, remains open.
- Umbilical Granuloma: Tumor-like mass of granulation tissue at the umbilicus, often caused by navel sucking or self-sucking.
Navel Ill/Joint Ill
- Definition: Disease of newborn animals (calves, foals, lambs, piglets) characterized by umbilical infection and/or polyarthritis.
- Incidence: Usually seen in young calves (< 1 week old).
- Causes: Infection enters via umbilical cord, soon after birth. Bacteria may spread to various parts, depending on spread route, resulting in joint ill or septicemia. May enter via gut or upper respiratory tract, especially in cases where colostrum intake is insufficient.
- Predisposing factors: Inadequate colostrum intake, poor hygiene. Risk higher in male calves due to slower drying of umbilical cord.
-
Symptoms:
- Navel (Omphalitis, Omphalophlebitis, Omphaloartertitis, Urachitis): Swollen, painful navel that doesn't dry up, abscess may develop, or firm cord, fever, loss of appetite.
- Joint (Infectious polyarthritis): Infection spreads, settling in joints (fetlock, carpal, hock, stifle); joints swell, are hot, and painful.
- Other symptoms: Drainage from lymph nodes (prescapular or popliteal), general lameness to non-weight-bearing, crab-like stance, muscle atrophy.
- Diagnosis: Clinical history, clinical symptoms, clinical examination (aseptic aspiration), ultrasonography, arthrocentesis, radiography (limited use in acute cases).
- Differential diagnosis: Localized peritonitis, patent urachus, umbilical hernia, fractures, osteomyelitis, rickets, muscular dystrophy.
- Treatment: Early treatment is critical, infected animals should be separated, treated with broad-spectrum antibiotics, and pain killers. Antibiotic treatment (penicillin) often continued after symptoms subside. Surgical intervention (joint lavage, abscess drainage) for large cases.
- Complications: Peritonitis, polyarthritis, meningitis, pericarditis, hepatic abscesses, umbilical hernia, septicemia, death.
- Prevention: Strict hygiene in calving boxes and ensuring complete drying of the navel, proper planning and preparation of calving areas, full immersion of umbilicus in strong povidone iodine solution, feeding calves sufficient amounts of colostrum within first 6 hours, especially by esophageal feeding method.
Patent Urachus
- Definition: Congenital condition where the urachus remains open. Related to membranous urethral diaphragms preventing urachus closure.
- Symptoms: Often associated with omphalitis, urine dripping from umbilicus, wet umbilical region, hair loss at umbilicus, multiple ulcers around umbilicus, ability to urinate from urachus alongside urethra.
- Diagnosis: Case history, clinical signs, ultrasonography.
- Treatment: Laparotomy, surgical removal of urachus and umbilical vessels, addressing any membranous diaphragms.
Umbilical Eventration
- Definition: Congenital anomaly where small intestines (jejunum) prolapses or are contained in sac of peritoneum at umbilicus.
- Symptoms: Extruded intestine, potentially rupture upon movement or necrosis due to damage from ischemia (especially prolonged cases).
- Treatment: For very recent cases (<3 hours), surgical intervention is possible, involving washing prolapsed lobes with warm saline solution, retaining the prolapse inside the abdomen for suturing, and systemic antibiotics.
Umbilical Granuloma
- Definition: Tumor-like mass of granulation tissue at umbilicus, often in calves, due to chronic inflammation from navel sucking or self-sucking.
- Symptoms: Loss of hair at umbilicus, secondary infection, slightly painful.
- Treatment: Ligation at the base, surgical removal; if left untreated, persistence into adulthood is possible.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
