UNIVERSITY OF NAIROBI

COLLEGE OF AGRICULTURE AND VETERINARY SCIENCES

FACULTY OF VETERINARY MEDICINE

DEPARTMENT OF CLINICAL STUDIES

SEMESTER II (2018/2019)

JCL 532: SURGERY

LARGE ANIMAL OPS REPORT

GROUP IV

LECTURER: DR. MWANGI

PRE-SURGICAL PARAMETERS:

Temperature: 38.5C Respiration: 32 breaths/minute

Pulse: 58 beats/minute Ruminal Movements: 1/minute

PRE-ANAESTHETIC PREPARATION:

The bull was starved for 24 hours prior to the surgery. A halter was placed on him, he was put in
a crush and the halter secured with a halter tie.

PRE-SURGICAL PREPARATION:

A region around the planned surgical site was shaved on the left flank of the bull, extending from
the 13th rib (on the cranial aspect) to the the tuber coxae caudally and from the dorsal midline of
the vertebral column dorsally, to the ventral midline (ventrally). The shaved area was scrubbed
three times with Chlorhexidine gluconate in a circular manner, discarding the swab between each
scrub. Thereafter, spirit was poured over.

ANESTHESIA:

A distal paravertebral thoracolumbar block was done.

SURGICAL PROCEDURE

A 15cm long vertical skin incision was made over the left paralumbar fossa, (bordered by the last
rib cranially, the transverse processes of the lumbar vertebrae dorsally and the tuba coxae
caudally), using a No. 2 scalpel blade -starting at about 4cm from the transverse processes of the
lumbar vertebrae. The incision went through the skin and subcutis. Thereafter, an incision of
similar length was made through the external and internal oblique abdominis muscles,
transversalis fascia and the peritoneum –facilitating entry into the abdomen.

The rumen was anchored to the skin using non-absorbable nylon no. 2 using a (seromuscular)
Cushing suture pattern. This was to pull the rumen over the skin to prevent spillage of the
ruminal contents into the abdomen. A demonstration was then done showing an alternative
method of anchoring the rumen using metal frame thingie and how to place a rumenotomy
shroud. The anchoring sutures were then cut with the scalpel blade and removed. The rumen was
returned back inside the abdomen.

Thereafter, the surgeons donned disinfected rectal palpation sleeves, exploratory laparotomy was
carried out and abdominal organs were identified and their location was noted as follows:

Diaphragm: Consistency, location, relation

Liver: Most of the liver was palpable on the right, with slightly sharp edges of the left Margin
and the parietal surface smooth.

Spleen: The spleen lies on left side above the rumen adjacent to the diaphragm and runs all the
way to Rib 13. Cranially the spleen borders diaphragm, ventrally it lies on the rumen, dorsally
it’s below the ribs while caudally it borders the kidney. The rumen is friable in consistency,
while the spleen is tougher and fibrous.

Rumen: Consis

Reticulum: Consis

Abomasum: Consis

Omasum: Consis

Small Intestine: Duodenum, jejunum and Ileum

It’s the first part of the small intestines extending from the pylorus to the jejunum and has a short
mesentery. It passes caudal on the right side of the abdominal cavity towards the pelvic inlet then
passes to the left side caudal to the root of the great mesentery and reflects cranially to join the
jejunum.

The cranial part of the duodenum is closely related to the liver and pancreas where it is attached
to the liver by the hepatoduodenal ligament and receives the bile and pancreatic ducts.

The duodenum is attached to the abdominal roof by the mesoduodenum, the cranial part of the
mesentery

Jejunum

This is the longest part of the small intestine between the duodenum and the ileum. It’s on the
right of abdominal cavity and surrounds the disc shaped ascending colon. It leads to the ileum at
the caudal attachment of the ileocecal fold.

Ileum

Is the short terminal part of the small intestine. Connects the small to large intestines at the
cecocolic junction where it forms the ileal orifice. The ileum is suspended by the mesoileum that
forms the caudal part of the mesentery. It is also attached to the caecum by the ileocecal fold.
Large Intestine: The large intestine consists of the Cecum, a blind sac, and the Colon, which
consists of ascending, transverse, and descending parts. The descending colon terminates as the
rectum and anal canal.

Cecum

In the ruminant the cecum is about 12 cm in diameter, and when full, its blind end projects as far
caudal as the pelvic inlet. Cranially, the cecum is continuous with the colon. The cecum is
demarcated from the colon by the ileum and communicates with the ileum through the ileal
orifice. Its rounded blind tip projects caudally from the supramental recess and floats high when
gas-filled.

Colon

The proximal part of the colon is the ascending colon. It is modified into a series of three loops
in the ruminant. A more significant difference lies in the “pearl necklace” appearance of the
centrifugal turns, in which the contents are already segmented into the pellets so characteristic of
the feces. The string of these pellets in the ascending colon is replaced by their massing in a
thicker column in the wider descending colon and rectum. The proximal loop (ansa proximalis)
forms an S shape that leads to the spiral loop (ansa spiralis). The spiral colon forms an orderly
spiraling mass on the left face of the great mesentery. The first portion of the spiral colon coils
toward the center of the mesentery (centripetally), reverses direction at the central flexure, then
spirals away from the center (centrifugally). The last part of the ascending colon, the distal loop
(ansa distalis) connects the spiral colon with the transverse colon.

Rectum: The transverse colon crosses from right to left, cranial to the cranial mesenteric artery,
which supplies the small intestine, the cecum, and the ascending colon, and continues caudally as
the descending colon to the rectum. An external anal sphincter of striated (i.e., voluntary) muscle
and an internal anal sphincter of smooth muscle characterize the walls of the most distal part of
the gastrointestinal tract as it opens to the exterior of the animal at the anus.

Kidneys: Consis

Bladder: Consis

Cowpers glands are located posterior and lateral to the membranous portion of the urethra at the
base of the penis between the 2 layers of fascia of the urogenital diaphragm in the deep perineal
pouch. They are enclosed by the fibers of the sphincter urethrae membranaceae muscle.
Seminal vesicles:

The Seminal vesicles are paired and located beneath the urinary bladder and lateral to the vas
deferens. The excretory duct of each seminal vesicle unites with the corresponding vas deferens
to form 2 ejaculatory ducts which pass through the substance of prostate gland before opening
separately into the verumontum of the prostate urethra.

Prostrate: The Prostate is a chestnut organ located at the neck of urinary bladder with the
urethra running in the middle.

CLOSURE:

The peritoneum and the transversalis fascia were closed together with absorbable chromic catgut
No.2 in a cruciate suture pattern. Then the external and internal oblique abdominis muscles
closed together using absorbable chromic catgut No. 3 in a cruciate suture pattern. Finally, the
skin and the subcutis were closed together using non-absorbable nylon No. 2 in a stitch suture
pattern.

POST-OPERATIVE CARE:

The incision wound was sprayed with alamycin after the surgery to reduce infection of the
wound. Additionally, post-operative antibiotics and painkillers were administered three times in
48-hour intervals.

The sutures were to be removed after 14 days.