The document summarizes veterinary gastrointestinal surgery techniques for treating gastric ulcers. It discusses the causes, signs, diagnosis, and surgical treatment methods for gastric and abomasal ulcers in cattle and calves. The key surgical treatment discussed is the Bilroth I technique, which involves ligating blood vessels near the pylorus, excising the pyloric sphincter and canal, and anastomosing the gastric mucosa to the duodenum using absorbable sutures.

1. • Veterinary Gastrointestinal surgery
(Part-I)
• Presented by
• Dr. Rekha Pathak
• Senior scientist , IVRI
The photographs have been collected from
different sources i.e. Internet, text books
etc

2. Gastric ulcer / Abomasal ulcer:
• assoc. with chronic
renal / hepatic
• mast cell neoplasia
• gastrin producing
neoplasia
• gastric neoplasia
• coagulation disorder
• FB / gun shot wound
• ICH

3. • Uremia
• Poison
• Snakebite
• Primary ulcers are
less common
• Ulcers secondary –
common
• Aspirin:
experimentally to
produce ulcers

4. • Pathophysiology:
• Gastric/ duodenal
mucosa/ covered
with mucus layer
(sulfated mucin
bound to epi. cells)

5. • Offers protection –
against –
corrosive /
digestive effects of
gastric acid and
pepsin (auto
digestion and
ulceration)

6. • Reduced mucosal
bl. Flow- local
ischemia – sepsis/
hemorrhagic shock
– sudden expulsion
of apical mucin –
circumscribed popn
of cells

7. • Reflux of bile salts
from duodenum to
stomach – bile salts –
more destructive than
pancreatic juices- act
as detergents that
solubilize lipid - cell
memb and inhibit the
ion transport sys.

8. • bile content – greatest – pyloric antrum –
ulcer region of stomach
• hyper secretion of HCL
– gastrinoma ie non beta islets cell tumour of
pancreas and hypergastinemia
– in renal failure (gastrin is removed by
kidneys)

9. – increased histamine: mastocytoma and Endotoxemia
and hemorrhagic shock
– NSAIDS- reduced secretion of mucus
• alters the biochemical composition of mucin
• ingestion of chemicals(arsenic ,cresote)
• Signs: vomiting (not immediately after
ingestion)
• eating – gastric pain- relieved by vomiting
• Hemet emesis and melena
• slow bleeding: coffee colored blood
• sudden - massive and semi clotted blood

10. • generalized peritonitis: gastric perforation
(mostly doesn’t occur due to effective sealing
with omentum)
• wt. loss – hepatic/ neoplastic
• additionally in calves : due to bleeding ulcers –
recumbent suddenly – cold extremity- subnormal
temp. tachycardia and dehydration- hypovolemic
shock and death 24 hrs

11. • Abomasal ulcers :
suckling calves and
adult cattle
(buffaloes)
• adult: 1st few wks of
partu.(stress and
lactation)
• Stress related
(summer months
independent of
partu.)

12. • Calves: dietary
transition from low
DM to high DM
• Trichobezoars
• Asso. With impaction
also

13. • Type I erosion and
ulcers with slight
hemorrhage
• Type II bleeding
ulcers
• Type III perforation
with acute
circumscribed
peritonitis
• Type IV perforation
with diffuse peritonitis

14. • Diagnosis:
• TRP ; pain on left
of xiphoid
• Abomasal ulcer:
pain on rt. side

15. • RG: double contrast:
create
pneumoperitoneum
and give barium
meal
• Barium: ulcers appear
as outpouchings from
lumen containing the
contrast material

16. • Fluoroscopy: helps in variable
positioning and pin point the site

17. • Endoscopy: not
in threatened
bleeding cases
(allows biopsies)
• Exploratory:
laparotomy if life
threatening
hemorrhage

18. Treatment
• Surgical excision
• Cranial midline incision
• Carefully palpate from fundus to pylorus
• If ulcers then – adhesion, serosal scarring
and irregular thickened areas on gastric
wall

19. • Inspect the
pancreas-
gastrinoma- p.
nodules
• If gastrinoma- en
block resection of a
lobe or complete
pancreas(90%
removal – no
endocrinal
insufficiency)

20. • If no ulcers found
• Open stomach- find the bleeding site- also
on pyloric antrum(equidistant from lesser /
greater curvature)
• Extend to duodenum if necessary

21. • Small ulcers :
elliptical incision-
mucosa closed –
simple continuous
– 3/0 or 4/0
absorbable chromic
and interrupted
Lambert on serosa
and muscularis
• Multiple ulcers on
pyloric part –
bilroth I
gastrectomy
technique

22. • Bilroth technique I :
ligate the rt. Gastric
artery near pylorus on
the lesser curvature
• Rt. Gastroepiploic
vessels ligated
• Take care not to injure
the pancreas
• Pyloric and gastric
branches supplying the
area to be resected are
ligated

23. • 2 st. intestinal
clamps are placed
across the pyloric
antrum
• another 2 are
placed distal to the
pylorus and avoid
the common bile
duct.
• Excise the pyloric
sphincter and canal

24. • Gastric mucosa is
apposed with 3-0
synthetic
absorbable suture
in an Cushing
pattern starting
from the lesser
curvature and
continuing towards
the greater
curvature

25. • Equal in size to the
duodenal dia
• Apposed – 3-0 –
synthetic absorbable,
polypropylene, or
nylon – lamberts
pattern
• Duodenum is then
anastamosed with
stomach