Changes

'''Secondary gastric dilation''' should be considered if there is persistent [[Colic Diagnosis - Clinical Signs|colic]], repeated retrieval of [[Colic Diagnosis - Naso-gastric Intubation|nasogastric reflux]], intestinal distension on [[Colic Diagnosis - Rectal Examination|rectal examination]] and clinical signs of [[Colic Diagnosis - Clinical Signs|endotoxaemia]].  These are all indications for '''exploratory laparotomy''' to look for an intestinal obstruction.   

'''Secondary gastric dilation''' should be considered if there is persistent [[Colic Diagnosis - Clinical Signs|colic]], repeated retrieval of [[Colic Diagnosis - Naso-gastric Intubation|nasogastric reflux]], intestinal distension on [[Colic Diagnosis - Rectal Examination|rectal examination]] and clinical signs of [[Colic Diagnosis - Clinical Signs|endotoxaemia]].  These are all indications for '''exploratory laparotomy''' to look for an intestinal obstruction.   

Failure to detect excessive gastric contents by stomach tube aspiration does not entirely preclude their presence.  Repeated attempts at obtaining reflux with frequent repositioning of the stomach tube are necessary. For reasons unknown, there are occasions when even the most diligent attempts at gastric decompression are unsuccessful in spite of large volumes of fluid being present.  It should also be emphasised that gastric impaction with solid food material is probably too firm to be siphoned by stomach tube.   

NB: ''excessive fluid within the stomach is not always detected by nasogastric intubation, despite repeated attempts with frequent repositioning of the tube. Furthermore, gastric impaction with solid food material may be too firm to be retrieved by this method.''(Proudman)    

'''Gastric rupture''' results in septic peritonitis which will be reflected in the nature of fluid collected by [[Colic Diagnosis - Abdominocentesis|abdominocentesis]]:

'''Gastric rupture''' results in septic peritonitis which will be reflected in the nature of fluid collected by [[Colic Diagnosis - Abdominocentesis|abdominocentesis]]: