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Stomach, small and large intestines
- Authors: Lorrie Gaschen and Daniel Rodriguez
- From: BSAVA Manual of Canine and Feline Ultrasonography
- Item: Chapter 11, pp 124 - 139
- DOI: 10.22233/9781910443118.11
- Copyright: © 2011 British Small Animal Veterinary Association
- Publication Date: January 2011
Abstract
Abdominal ultrasonography has become in many instances a part of the minimum database in conjunction with abdominal radiography for the assessment of intestinal disease. Some of the most common indications for gastrointestinal ultrasonography include: persistent or chronic vomiting; diarrhoea; abdominal pain; palpable abdominal mass; palpable thickening of the small intestinal loops; weight loss and anorexia; suspected ingestion of foreign bodies; staging of neoplasia; suspected hernias. This chapter explains the value of ultrasonography compared with radiography and computed tomography. The chapter covers the stomach, duodenum, jejunum and large intestine. This chapter contains 12 video clips.
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Functional ileus.
This clip shows functional ileus in a dog with haemorrhagic gastroenteritis. The normal canine ileocaecal junction is seen in the first part of the clip, followed by the stomach and small intestines. The ileocaecal junction appears as a wagon wheel in cross-section and can be found by tracing the colon to the ascending portion and caecum, or by identifying the ileum on the right side of the abdomen medial to the duodenum. In this dog the small intestines are mild to moderately dilated with anechoic fluid in the lumen and show no sign of peristalsis. Any cause of functional ileus will cause this ultrasonographic appearance.
Gastric oedema.
Gastric wall oedema in a dog with chronic vomiting and diarrhoea. The gastric wall is diffusely hyperechoic and mildly thickened. The wall layering is not distinct. Differential diagnoses for this finding include gastric wall oedema, gastritis and neoplasia. Biopsy samples confirmed the presence of gastric wall oedema.
Gastric lymphoma.
The stomach of this dog has a focal wall mass that is poorly delineated, somewhat rounded and diffusely hypoechoic. There is a loss of wall layering associated with the mass, which was located in the gastric body.
Pseudolayering.
Gastric carcinoma showing pseudolayering in a dog. The stomach of this dog is shown in cross-section at the level of the body and antrum. The stomach wall is thickened and hypoechoic. A number of thick layers, alternating from hypoechoic to hyperechoic, represent pseudolayering, which is commonly seen with neoplasia, especially carcinoma.
Normal duodenal contractions.
Normal postprandial contractions of the canine duodenum. When the stomach is full and emptying in a normal manner, antegrade movement of the ingesta can be seen as it enters the duodenum. The ingesta is propulsed aborally with regular contractions of the duodenum.
Normal feline pylorus.
The pylorus is easier to identify in cats than in dogs. By following the gastric antrum to the right, the pylorus and duodenum are located in the midline of the abdomen and close to the hilus of the liver and portal vein. A mid-sagittal probe position can be used to identify the feline pylorus; whereas, in the dog, a right lateral position of the probe is necessary. Power Doppler was used to identify the position of the portal vein. Ingesta can be seen moving from the stomach into the duodenum as a rapidly moving bolus.
Normal duodenal papilla.
This clip shows the normal duodenal papilla and common bile duct in a dog. The papilla and entrance to the normal bile duct are visible. The papilla is located close to the cranial curvature of the duodenum and can be difficult to identify in deep-chested dogs. The papilla in dogs appears as a slit-like opening in the duodenal wall; whereas, in cats it has the appearance of a small nodule where the bile duct enters. The common bile duct appears thin-walled with a narrow anechoic lumen.
Inflammatory polyp.
This clip shows an inflammatory polyp at the duodenal papilla in a dog with icterus. The proximal duodenum contains anechoic fluid. The common bile duct can be seen as a mildly dilated tubular structure with anechoic contents, adjacent to the papilla and duodenum. The papilla is markedly enlarged and diffusely hyperechoic, and has caused obstruction of the bile duct. An inflammatory polypoid growth was diagnosed.
Jejunal foreign body.
This clip shows a jejunal foreign body in a dog presented with vomiting of 3 days duration. A dilated jejunal segment is visible to the left of the screen and can be traced to an intraluminal, irregularly shaped, hyperechoic structure with shadowing. The foreign body was a fruit pit.
Jejunal lymphoma.
Lymphoma of the jejunum associated with stenosis and foreign body obstruction in a cat. Focal and severe thickening of a jejunal segment is shown, with loss of wall layering and diffuse hypoechogenicity. Proximal to the wall infiltration the jejunum is dilated, and multiple, irregularly shaped structures are present in the lumen with clean acoustic shadowing. A number of empty jejunal segments can be identified adjacent to the affected segment.
Hypereosinophilic syndrome.
This clip shows hypereosinophilic syndrome in a cat with chronic vomiting. The small intestines have a generalized thickened and hypoechoic muscularis layer, which is 2--3 times thicker than the mucosa. The intestines are mildly dilated. Histopathology showed severe eosinophilic infiltration of the jejunal wall, most prominently in the muscular layer. Differential diagnoses for this finding should include lymphoma.
Colonic carcinoma.
Carcinoma of the colon in a dog with constipation and straining to defecate. The colon proximal to the mass is distended and filled with gas. As the gas-filled colon is traced distally, a focal and severe wall thickening with loss of wall layering is seen, resulting in stenosis. Histopathology confirmed the diagnosis of a carcinoma.