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