Changes

 

Also known as: '''''Gastric Rupture

Also known as: '''''Gastric Rupture

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.''<ref name="Proudman">Proudman, C.J, Baker, S.J (1994) Satellite Article: Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref>   

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.''<ref name="Proudman">Proudman, C.J, Baker, S.J (1994) Satellite Article: Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref>   

'''Gastric rupture''' results in septic peritonitis which will be reflected in the nature of fluid collected by [[Colic Diagnosis - Abdominocentesis|abdominocentesis]]<ref name="Proudman">Proudman, C.J, Baker, S.J (1994) Satellite Article: Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref>:

'''Gastric rupture''' results in septic peritonitis which will be reflected in the [[Colic - Peritoneal Fluid Analysis|nature of fluid collected by abdominocentesis]]<ref name="Proudman">Proudman, C.J, Baker, S.J (1994) Satellite Article: Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref>:

*Foetid, turbid sample containing particulate matter

*Foetid, turbid sample containing particulate matter

*White cell count >40 x 10⁹/l

*White cell count >40 x 10⁹/l

'''Surgical treatment''':  

'''Surgical treatment''':  

The surgical options for managing gastric disease are limited since the equine stomach is difficult to access surgically.  Extending the midline laparotomy incision cranially may improve access slightly but also increases the risk of post operative wound problems.<ref name="Proudman">Proudman, C.J, Baker, S.J (1994) Satellite Article: Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref>  Gastrotomy and removal of impacted food material has been reported<ref>Clayton-Jones, D.G, Greatorex, J.C, Stockman, M.J.R, Harris, C.P.J (1972) Gastric impaction in a pony: Relief via laparotomy.  ''Equine Vet J'', 4:98-99.  In: Proudman, C.J, Baker, S.J (1994) ''Satellite Article'': Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref>but carries a high risk of gross peritoneal contamination. For gastric rupture, surgical success has been reported for repairing partial thickness tears<ref>Steenhaut, M, Vlaminck, K, Gasthuys, F (1986) Surgical repair of a partial gastric rupture in a horse.  ''Equine Vet J'', 18:331-332.  In: Sanchez, L.C (2010) ''Other Disorders of the Stomach'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), ''Saunders'', Chapter 15.</ref> and also in one case of a full thickness rupture.<ref>Hogan, P.M, Bramlage, L.R, Pierce, S.W (1995) Repair of a full-thickness gastric rupture in a horse.  ''J Am Vet Med Assoc'', 207:338-340.  In: Sanchez, L.C (2010) ''Other Disorders of the Stomach'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), ''Saunders'', Chapter 15.</ref>

The surgical options for managing gastric disease are limited since the equine stomach is difficult to access surgically.  Extending the midline laparotomy incision cranially may improve access slightly but also increases the risk of post operative wound problems.<ref name="Proudman">Proudman, C.J, Baker, S.J (1994) Satellite Article: Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref>  Gastrotomy and removal of impacted food material has been reported<ref>Clayton-Jones, D.G, Greatorex, J.C, Stockman, M.J.R, Harris, C.P.J (1972) Gastric impaction in a pony: Relief via laparotomy.  ''Equine Vet J'', 4:98-99.  In: Proudman, C.J, Baker, S.J (1994) ''Satellite Article'': Gastric disease in the adult horse: a clinical perspective.  ''Equine Vet Educ'', 6(4):178-184.</ref> but carries a high risk of gross peritoneal contamination. For gastric rupture, surgical success has been reported for repairing partial thickness tears<ref>Steenhaut, M, Vlaminck, K, Gasthuys, F (1986) Surgical repair of a partial gastric rupture in a horse.  ''Equine Vet J'', 18:331-332.  In: Sanchez, L.C (2010) ''Other Disorders of the Stomach'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), ''Saunders'', Chapter 15.</ref> and also in one case of a full thickness rupture.<ref>Hogan, P.M, Bramlage, L.R, Pierce, S.W (1995) Repair of a full-thickness gastric rupture in a horse.  ''J Am Vet Med Assoc'', 207:338-340.  In: Sanchez, L.C (2010) ''Other Disorders of the Stomach'' in Reed, S.M, Bayly, W.M. and Sellon, D.C (2010) '''Equine Internal Medicine''' (Third Edition), ''Saunders'', Chapter 15.</ref>

==Prognosis==

==Prognosis==

The prognosis for survival may be excellent in most cases of gastric dilation<ref name="Merck">Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''', ''Merial''.</ref> but gastric rupture is usually '''fatal''' because of widespread contamination of the peritoneal cavity, septic peritonitis, and septic shock. '''Food engorgement''' also carries the risk of secondary laminitis.

The prognosis for survival may be excellent in most cases of gastric dilation<ref name="Merck">Merck & Co (2008) '''The Merck Veterinary Manual (Eighth Edition)''', ''Merial''.</ref> but gastric rupture is usually '''fatal''' because of widespread contamination of the peritoneal cavity, septic peritonitis, and septic shock. '''Food engorgement''' also carries the risk of secondary laminitis.

==Literature Search==

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|flashcards = [[Equine Internal Medicine Q&A 01]]

|literature search = [http://www.cabdirect.org/search.html?q=title:(gastric)+AND+(title:(dilat*)+OR+title:(ruptur*))+AND+od:(horses) Gastric Dilatation or Rupture in horses publications]

[[Category:Expert_Review]]

[[Category:Expert_Review - Horse]]

[[Category:Surgical_Colic_in_the_Horse]]

[[Category:Surgical_Colic_in_the_Horse]]

[[Category:Colic - Gastric Causes]]

[[Category:Colic - Gastric Causes]]

[[Category:Medical Colic in the Horse]]

[[Category:Medical Colic in the Horse]]

[[Category:Stomach Diseases - Horse]]

[[Category:Stomach Diseases - Horse]]