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PATHOLOGY OF THE INTESTINE (Functional consequences of injury…
PATHOLOGY OF THE INTESTINE
Functional consequences of injury
Malabsorption
reduced surface area
villous atrophy
infilatration
inflammatory cells
neoplastic cells
may follow from impaired digestion
examples
lymphosarcoma
Johne's disease
:red_flag: Diarrhoea
Types of diarrhoea
Secretory
secretions exceed absorption
bacterial toxins
E.coli
toxins inhibit NaCl and water absorption
increase secretion of Cl-
Malabsorptive
increased osmotic pressure
unabsorbed digesta
water moves into lumen
Exudative
inflammation
enteritis
leaky intracellular junctions
loss of integrity of mucosa
increased vascular permeability
oedema
increase in hydrostatic pressure
portal hypertension
right sided congestive heart failure
increased plasma volume
decreased oncotic pressure in vessels
hypoalbuminaemia
Ddx
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Hypermotility
prokinetic drugs
laxatives
increased bulk and fluidity of faeces
impaired colonic absorption
excess fluid
Disturbances of intestinal motility
Hypermotility
spasmodic colic
Hypomotility
ileus
Protein losing enteropathy
excess loss of protein into intestinal lumen
hypoproteinaemia
causes
severe inflammatory disease
protein loss in exudate
increased mucosal permeability
erosions
loss of tight junctions
lymphangiectasia
obstruction of lymphatic vessels
loss of lymph
protein and chylomicron rich
Impaired digestion
Why
Lack of digestive emzymes
Impaired liver and pancreatic function
Reduced bile and pancreatic emzymes
Loss of commensal flora
Disturbances of fluid balance
secretion and reabsorption
Congenital anomalies
Segmental anomalies
incomplete
stenosis
complete
atresia
atresia coli
atresia ani
Hernia
Umbilical hernia
Physical distrubance
Obstruction
Functional
Intestinal ileus
stasis
post-surgery
metabolic
flaccid, distended with gas/ ingesta
:red_flag: Equine Grass Sickness
Clostridium botulinum type C
fluid in small intestine and stomach
impacted large intestine
dark mucoid coating over mucosa
degenerative lesions in autonomic nerve ganglia
Feline dysautonomia
Physical
Intraluminal
Food impaction
Foreign bodies
Intramural
Neoplasia
Inflammatory lesions
abscess
granuloma
scar tissue
Extrinsic
Adhesions
Neoplasia
Prostate enlargement
Displacements
Hernia
Reducible
Non-reducible
Incarcerated
obstruction of venous drainage
obstruction of lumen
congestion
oedema
adhesions
peritonitis
rupture
death
Volvulus
Torision
Intussusception
telescoping
causes
foreign body
abscess
heavy parasitism
idiopathic
previous intestinal surgery
enteritis
motility disorders
Rectal prolapse
tenesmus
Vascular disturbances
Intestinal hypoxia
obstruction of efferent veins
obstruction of afferent arteries
reduced blood flow
Venous congestion
strangulating lesions
intestinal displacements
intussusception
Arterial thromboembolism
non-strangulation infarction
Strongylus vulgaris larvae migrating through cranial mesentertic artery in the horse
Inflammation
Secretory diarrhoea
Colibacillosis
E.coli
bacteria adhere to enterocytes
toxins stimulate loss of NaCl and water
Haemorrhagic enteritis
Clotridial enterotoxaemia
Canine parvovirus
Granulomatous enteritis
Johne's disease
FIP
Necrotising enteritis
Salmonellosis
Coccidiosis
Ulcerative enteriris
Cyathostomosis
Inflammatory bowel disease
malabsorption
chronic diarrhoea
Lymphocytic/plasymocytic enteritis
Eosinophilic enteritis
Lymphangiectasia
lymphatic obstruction
dilatation of lymphatic vessels including lacteals
oedema
Neoplasia
Intestinal adenoma
Intestinal adenocarcinoma
Adenocarcinoma of the apocrine glands of the anal sac
Adenoma of perianal glands
Lymphoma
Gastrointestinal stromal tumour
Peritoneal Pathology
Peritonitis
Secondary to other abdominal pathology
Localised
Generalised
Acute
Chronic
Causes
Chemical
Bacterial
Viral
:red_flag:FIP
Parasitic
Fasciola hepatica
ruminants
Strongylus vulgaris
horses
Parasitic Cysts
Neoplasia
Mesotheliomas
Lipomas
Secondary tumours
ovarian carcinomas
bile duct carcinomas
pancreatic carcinomas
intestinal carcinomas
gastric SCC
carcinosis