Kirurško liječenje kolike: kako donositi odluke
Kira L. Epstein, DVM, Dipl ACVS, ACVECC, Clinical Professor
Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, USA; e-mail: firstname.lastname@example.org
Izvor: Knjiga sažetaka 3. međunarodnog veterinarskog specijalističkog simpozija “Hitna i intenzivna skrb u veterinarskoj medicini”
A case study will be used to highlight some of the factors that can be used to make the difficult decisions surrounding colic surgery.
The key questions to answer when deciding whether to recommend surgical exploration are: where is the location of the lesion and what is the underlying mechanism? Colic evaluation begins with consideration of signalment and history and continues with a basic colic exam including physical examination, examination per rectum, and nasogastric intubation. Further information can be gained by additional diagnostics including ultrasound, abdominocentesis, and bloodwork.
The key questions to answer during surgery are: what is the best surgical treatment for the lesion and what are the best techniques for minimizing post-operative complications? For both small and large intestinal strangulating lesions, the decision whether or not to resect and how to perform a resection remain controversial. A variety of risk factors for and methods to minimize the risk of adhesions, post-operative ileus, and incisional infections have been evaluated.
The key questions to answer during post-operative management are: how to minimize and manage post-operative complications and how/if to return the horse to their previous diet and activity? Management of the common post-operative complications like post-operative ileus, adhesions, incisional infection, and recurrent colic remain challenging. In horses that recover from colic surgery, prognosis for return to previous level of activity has been shown to be good. However, there is little information on the best rehabilitation program.
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