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Acute Abdomen: What To Do - Coggle Diagram
Acute Abdomen: What To Do
promptly recognize
vital signs
neuro
fluid balance
pain
resuscitation and/or stabilize
analgesia
IV fluid
abx
narrow the ddx/establish diagnosis
questions
presenting complaint
last normal
progression
fequency
predisposition
vaccinations and deworming
detailed q's
food/water intake
urine, defecation
vomting
foreign body, toxins, food poisoning
trauma
determine if surgical
sign of surgical emergency
unresponsive to analgesics
progressive peritoneal effusion +/- pain
hypoglycemia, fever, marked leukocytosis
GI bleeding with anemia
abdominal trauma
intractable vomiting
shock
inadequate tissue oxygenation
conditions indicated
GDV
large breed dogs
hypersalivation
abdominal distention
unproductive vomiting
"double bubble"
method
shock fluid bolus
gastric decompression
CBC/chem
surgical goals
reposition stomach
remove necrotic tissue
gastropexy
ECG
orogastric tube
trocharize
blood pressure
lactate
foreign body
IV fluids 1-2h pre-op
full exploratory
options
enterotomy
linear FB
no necrosis
resection + anastomosis
necrosis
:forbidden: descending duodenum and pancreas
method
clamp
ligate jejeunal and arcade vessels
mesenteric end longer than antimesenteric border
may need to transect at an angle to match diameters
leak test
septic peritonitis
causes
primary
post-op complication
GI ulcer
GI neoplasia
gallbladder rupture/perf
intussesception
GDV
abscess
body wall injury
goals
remove underlying contamination source
reduce bacterial load
removal foreign material
prevent persistent/recurrent effusion
method
full abdo explore
remove necrotic and foreign matieral
copious lavage
suction drain
50% mortality
mesenteric volvulus
rare but fatal
rapid progressive abdominal distention
hematochezia
colonic volvulus
rare
even rarer in old dogs
complications
septic peritonitis
dehiscence
adhesions
short bowel syndrome
ileus
monitor for deterioration