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Gastric Dilatation and Volvulus (view source)
Revision as of 08:39, 21 August 2009
, 08:39, 21 August 2009no edit summary
===Haematology===
===Haematology===
*Increased haematocrit
*DIC (thrombocytopaenia, increased firbin degradation products, prolonged patial thromboplastin time and reduced antithrombin III.
===Biochemistry===
===Biochemistry===
Most commonly find hypokalaemia and metabolic acidosis. The acidosis is caused hypoperfusion and anaerobic metabolism leading to lactic acid accumulation. Respiratory acidosis and alkalosis may also be present due to hypo- and hyperventilation.
===Diagnostic imaging===
===Diagnostic imaging===
Best performed after fluid therapy and gastric decompression. It allows distinction between GD and GDV:
*Gastric dilatation: gas distension, on Right Lateral shows air in the fundus.
*Gastric dilatation and volvulus: pylorus moves dorsally and left with a compartmentalized stomach.
A right lateral view will show a large fundus ventrally, with a smaller gas filled pylorus located dorsally to that. These are seperated by a soft tissue strip. The contrast of the abdomen may be lost indicating peritonitis or haemabdomen. Gastric rupture would show as pneumoperitoneum and increased contrast.
==Treatment==
==Treatment==
The most important first line treatments are [[Principles of Fluid Therapy|fluid therapy]] and gastric decompression
The most important first line treatments are [[Principles of Fluid Therapy|fluid therapy]] and gastric decompression
===Fluid therapy===
===Fluid therapy===
Should be individualised to the patient due to the varying nature of the acid-base disturbances.
===Gastric decompression===
===Gastric decompression===