no edit summary
Line 31: Line 31:  
*'''Broken claws'''
 
*'''Broken claws'''
 
*'''Fractured mandibular symphysis'''
 
*'''Fractured mandibular symphysis'''
*'''Pelvic, spinal or appendicular fractures''
+
*'''Pelvic, spinal or appendicular fractures'''
 
*'''Tail pull injuries'''
 
*'''Tail pull injuries'''
 
*'''Wounds'''
 
*'''Wounds'''
Line 68: Line 68:     
===Surgical Repair===
 
===Surgical Repair===
Traditionally, it was recommended that at least 24 hours elapse from the traumatic event until the rupture was repaired to reduce perioperative mortality but newer evidence suggests that, if animals are adequately stabilised before this, surgical repair may still be successful.  If possible, the repair should be conducted in the first week after rupture as fibrous adhesions begin to form after this time.  Post-operative mortality is also higher if the rupture is repaired after a very long interval (more than 1 year) due to the formation of extensive fibrous adhesions.  
+
Traditionally, it was recommended that at least 24 hours elapse from the traumatic event until the rupture was repaired to reduce perioperative mortality but newer evidence suggests that, if animals are adequately stabilised before this, surgical repair may still be successful <ref> Gibson TW, Brisson A and Sears W (2005): '''Perioperative survival rates after surgery for diaphragmatic hernia in dogs and cats: 92 cases''' J of the Am Vet Med Assoc '''227''' 105-109.</ref>.  If possible, the repair should be conducted in the first week after rupture as fibrous adhesions begin to form after this time.  Post-operative mortality is also higher if the rupture is repaired after a very long interval (more than 1 year) due to the formation of extensive fibrous adhesions.  
    
The defect is approached by a ventral midline coeliotomy (which may be extended cranially beside the xiphisternum or into a median sternotomy) and the abdominal organs are retracted.  Fibrinous adhesions can be easily separated but strangulated organs (such as torsed liver lobes or loops of small intestine) should be sacrificed and resected.  If the rupture has been present for a long period, its fibrous edges may be debrided before suturing using polydioxanone in a continuous pattern.  If there is a large defect that cannot be closed without tension, the following approaches may be used:
 
The defect is approached by a ventral midline coeliotomy (which may be extended cranially beside the xiphisternum or into a median sternotomy) and the abdominal organs are retracted.  Fibrinous adhesions can be easily separated but strangulated organs (such as torsed liver lobes or loops of small intestine) should be sacrificed and resected.  If the rupture has been present for a long period, its fibrous edges may be debrided before suturing using polydioxanone in a continuous pattern.  If there is a large defect that cannot be closed without tension, the following approaches may be used:
Line 87: Line 87:  
==References==
 
==References==
 
[http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=11491 Image of traumatic diaphragmatic hernia with displaced intestine in a dog by Cornell Veterinary Medicine]
 
[http://w3.vet.cornell.edu/nst/nst.asp?Fun=Image&imgID=11491 Image of traumatic diaphragmatic hernia with displaced intestine in a dog by Cornell Veterinary Medicine]
   
Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition) Mosby Elsevier
 
Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition) Mosby Elsevier
 
+
<references/>
    
[[Category:Stomach_and_Abomasum_-_Pathology]]
 
[[Category:Stomach_and_Abomasum_-_Pathology]]
829

edits