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[[Image:Equine Internal Medicine Q&A 01A.jpg|centre|500px]]<br>

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'''This stomach lesion in the image was found in a four-year-old horse which was killed because of an orthopaedic problem. It shows a classic rupture of the stomach wall along the greater curvature. The haemorrhage along the rupture line can help to distinguish this ante-mortem rupture from the equally common post-mortem rupture. This seromuscular rupture had occurred without an associated rupture of the mucosa.'''

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<FlashCard questions="2">
|q1=How can gastric rupture occur?
|a1=
Gastric rupture can occur as a result of overeating, especially readily fermentable foodstuffs such as grain, grass and foodpulp. <br><br>
More commonly gastric rupture is associated with some form of intestinal obstruction that causes small-intestine contents to reflux into the stomach, where they accumulate and cause distension. <br><br>
The horse has a powerful lower oesophageal sphincter that prevents vomiting. The distension of the stomach may therefore become progressive, resulting in a rising intragastric pressure that ultimately may lead to rupture. <br><br>
Examples of obstructions that can result in gastric rupture include
*mechanical obstructions of small intestine,
*paralytic ileus of the intestines (eg. secondary to peritonitis or enteritis, or post-operative ileus),
*grass sickness (in the UK),
*intra-abdominal abscesses and adhesions.
|l1=
|q2=What are the clinical signs associated with a complete rupture of the stomach wall?
|a2=
Signs of gastric rupture are usually preceded by severe pain, increased heart rate, distended abdomen and sometimes retching. Cyanosis may be present. <br><br>
Once the stomach ruptures, the signs of pain may disappear, but the horse develops signs related to acidosis, toxaemia and peracute peritonitis, causing severe depression, sweating and anxiety. <br><br>
Death follows within a few hours.
|l2=

</FlashCard>

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