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Gastric Dilation and Rupture - Horse (view source)
Revision as of 16:22, 10 August 2010
, 16:22, 10 August 2010no edit summary
Clinical signs associated with gastric dilatation include severe abdominal pain, tachycardia, and retching. The mucous membranes may be pale. Classically, these acute signs are replaced by relief, depression, and toxemia after the stomach has ruptured. The prognosis for survival may be excellent in most cases of gastric dilatation, but gastric rupture is fatal.
Clinical signs associated with gastric dilatation include severe abdominal pain, tachycardia, and retching. The mucous membranes may be pale. Classically, these acute signs are replaced by relief, depression, and toxemia after the stomach has ruptured. The prognosis for survival may be excellent in most cases of gastric dilatation, but gastric rupture is fatal.
(Merck)
(Merck)
Dilation is primary, secondary or idiopathic. Causes of primary: gastric impaction, grain engorgement, excessive water intake after exercise, aerophagia and parasitism(141, 146). Secondary more common and can result from primary intestinal ileus or small or large intestinal obstruction. Time to development of gastric reflux is proportional to the distance to the intestinal segment involved, with duodenal obstruction resulting in reflux within 4 hours(147).
==Clinical signs of gastric dilation==
*Acute colic
*Ingesta appears at nares in severe cases
When rupture occurs, horses may exibit signs of relief. Tachypnea, tachycardia, sweating and muscle fasciculations are consistent with peritonitis and shock.
==Lab abnormalities(141)==
*Haemoconcentration
*Hypokalaemia
*Hypochloraemia
==Aetiology of gastric rupture==
*Secondary to small intestinal obstruction
*Primary gastric dilation
*Idiopathic gastric dilation
'''Risk factors for gastric rupture(146, 148)'''
*Feeding grass hay
*Not feeding grain
*Gelding
*Non-automatic water source
Nasogastric intubation does not preclude the possibility of gastric rupture, and the amount of reflux obtained before rupture is highly variable(146)
Usually occurs along the greater curvature. In horse with rupture due to gastric dilation, the seromuscualris likely wekaens and tears before the mucosa(146,148). In rupture secondary to gastric ulceration, there is usally full-thicknees tearing of equal size in all layers.
==Treatment==
Surgical repair has been reported for partial thickness tears(149) and one case of a full thickness repair(150).
==Prognosis==
Gastric rupture is usually fatal because of widespread contamination of the peritoneal cavity, septic peritonitis, and septic shock.
[[Category:To_Do_-_Nina]]
[[Category:To_Do_-_Nina]]
[[Category:Surgical_Colic_in_the_Horse]]
[[Category:Surgical_Colic_in_the_Horse]]