View source for Small Animal Emergency and Critical Care Medicine Q&A 09

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'''Your triage nurse alerts you that a three-year-old, male Coonhound (40 kg) with a few hours’ history of non-productive retching and pacing has entered the hospital. Primary survey reveals poor perfusion, rapid and irregular heart rate, and a tympanic, distended cranial abdomen. A lateral radiograph reveals gastric dilatation and volvulus.'''

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<FlashCard questions="3">
|q1=What are the pros and cons of the following surgical procedures for preventing gastric volvulus from recurring: 
*circumcostal gastropexy; 
*antral incisional gastropexy; 
*tube gastropexy; 
*midline abdominal closure gastropexy?
|a1=
Circumcostal gastropexy. 
:*Pros: most reliable adhesions obtained. 
:*Cons: time-consuming preparation; potential for rib fractures; potential for entering pleural space and causing pneumothorax.<br>
Antral incisional gastropexy. 
:*Pros: rapid technique with less technical difficulty. 
:*Cons: none. <br>
Tube gastropexy. 
:*Pros: ability for postoperative decompression and feeding control. 
:*Cons: requires time for fistula formation before tube can be removed; requires exposure of the gastric lumen. <br>
Midline abdominal closure gastropexy. 
:*Pros: rapid technique. 
:*Cons: makes a reapproach to the cranial abdomen very difficult.
|l1=Gastric Dilatation and Volvulus#Treatment
|q2=What vessels are most commonly torn during a gastric dilatation/volvulus episode, and where are these located?
|a2=
Short gastric arteries and left epiploic artery along the greater curvature of the fundus.
|l2=Monogastric Stomach - Anatomy & Physiology#Vasculature
|q3=What surgical findings would indicate that a splenectomy is required?
|a3=
*Dark/black areas suggesting an infarction/ischemia; 
*lack of palpable pulses in the splenic hilus suggesting arterial thrombosis; 
*disseminated masses that may be neoplastic; 
*bleeding mass; 
*uncontrollable hemorrhage of the spleen.
|l3=Gastric Dilatation and Volvulus#Treatment
</FlashCard>

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