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Imaging the gastrointestinal tract, liver and pancreas
/content/chapter/10.22233/9781910443361.chap3
Imaging the gastrointestinal tract, liver and pancreas
- Author: Robert T. O’Brien
- From: BSAVA Manual of Canine and Feline Gastroenterology
- Item: Chapter 3, pp 22 - 33
- DOI: 10.22233/9781910443361.3
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Copyright:
- Publication Date: January 2005
Abstract
PLEASE NOTE THAT A MORE RECENT EDITION OF THIS TITLE IS AVAILABLE IN THE LIBRARY
Many clinical signs of gastrointestinal (GI) disease are vague and do not localize precisely to a particular organ. Imaging is often very important both to identify an obvious abnormality and to gain confidence that no obvious condition exists that would dictate a surgical emergency. Radiography is the most common imaging modality in veterinary medicine. While hazardous if misused, few modalities can match the clinical utility of radiography for providing overview of the neck, thorax and abdomen in clinical evaluation of the entire GI tract. This chapter provides an overview of imaging modalities and stresses the indications, contraindications, and normal and abnormal findings of Gastrointestinal imaging; Liver imaging; and Pancreatic imaging.
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Figures
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3.2
Right lateral radiograph of 6-year-old male neutered Dobermann with a 3-hour history of retching. Note the gastric dilatation volvulus with air-filled pylorus (*) in cranial dorsal position. Pneumoperitoneum is seen secondary to gastric wall necrosis, as shown by the free air caudal to the diaphragm (white arrow) and the increased serosal detail of intestinal loops (black arrow). © 2005 British Small Animal Veterinary Association
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3.2
Right lateral radiograph of 6-year-old male neutered Dobermann with a 3-hour history of retching. Note the gastric dilatation volvulus with air-filled pylorus (*) in cranial dorsal position. Pneumoperitoneum is seen secondary to gastric wall necrosis, as shown by the free air caudal to the diaphragm (white arrow) and the increased serosal detail of intestinal loops (black arrow).
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3.3
Radiograph of a 5-year-old intact male Golden Retriever with progressive vomiting for 48 hours. The dog had eaten a terrycloth wristband, and evidence of small intestine (SI) obstruction is demonstrated by loops of SI that are wider (serosa-to-serosa) than the height of the vertebral endplate of L2. © 2005 British Small Animal Veterinary Association
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3.3
Radiograph of a 5-year-old intact male Golden Retriever with progressive vomiting for 48 hours. The dog had eaten a terrycloth wristband, and evidence of small intestine (SI) obstruction is demonstrated by loops of SI that are wider (serosa-to-serosa) than the height of the vertebral endplate of L2.
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3.4
(a) Right and (b) left lateral radiographs of 3-year-old female spayed Domestic Short-hair cat with gastric dilatation caused by pyloric obstruction. The stomach appears as a soft tissue mass, indistinguishable from a liver mass, on the right lateral projection. On the left lateral projection the luminal gas rises to the non-dependent pylorus and descending duodenum providing better contrast and verification of the cause of the cranial organomegaly. © 2005 British Small Animal Veterinary Association
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3.4
(a) Right and (b) left lateral radiographs of 3-year-old female spayed Domestic Short-hair cat with gastric dilatation caused by pyloric obstruction. The stomach appears as a soft tissue mass, indistinguishable from a liver mass, on the right lateral projection. On the left lateral projection the luminal gas rises to the non-dependent pylorus and descending duodenum providing better contrast and verification of the cause of the cranial organomegaly.
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3.5
Lateral radiographic projection of 4-year-old German Shepherd Dog with 2 days’ duration of vomiting following ingestion of a linear foreign body. Note the abnormally shaped small intestine. The gas pockets in the small intestines in the ventral abdomen are round to ovoid, the loops are bunched and the intestines are bending in tight corners. © 2005 British Small Animal Veterinary Association
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3.5
Lateral radiographic projection of 4-year-old German Shepherd Dog with 2 days’ duration of vomiting following ingestion of a linear foreign body. Note the abnormally shaped small intestine. The gas pockets in the small intestines in the ventral abdomen are round to ovoid, the loops are bunched and the intestines are bending in tight corners.
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3.6
(a) Left lateral and (b) ventrodorsal radiographs of a 9-year-old German Shepherd Dog with a 6-month history of regurgitation. Note the wall of the oesophagus (white arrows) on left lateral and ventrodorsal projections. Regions of alveolar consolidation are seen in the right middle and caudal lung lobes. The dog was diagnosed with idiopathic megaoesophagus and aspiration pneumonia. © 2005 British Small Animal Veterinary Association
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3.6
(a) Left lateral and (b) ventrodorsal radiographs of a 9-year-old German Shepherd Dog with a 6-month history of regurgitation. Note the wall of the oesophagus (white arrows) on left lateral and ventrodorsal projections. Regions of alveolar consolidation are seen in the right middle and caudal lung lobes. The dog was diagnosed with idiopathic megaoesophagus and aspiration pneumonia.
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3.7
(a) Survey and (b) negative contrast ventrodorsal projections of the cranial abdomen of a 1-year-old Cardigan Welsh Corgi with vomiting of 4 months duration. The survey radiograph was normal but on the negative contrast gastrogram, air in the proximal descending duodenum surrounds a round soft tissue filling defect (arrowed). The dog had a large acorn removed endoscopically. © 2005 British Small Animal Veterinary Association
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3.7
(a) Survey and (b) negative contrast ventrodorsal projections of the cranial abdomen of a 1-year-old Cardigan Welsh Corgi with vomiting of 4 months duration. The survey radiograph was normal but on the negative contrast gastrogram, air in the proximal descending duodenum surrounds a round soft tissue filling defect (arrowed). The dog had a large acorn removed endoscopically.
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3.9
Ventrodorsal radiograph of a 5-year-old intact Labrador Retriever bitch with lethargy for 3 days, obtained 15 minutes after administration of 13 ml/kg of 20% weight/volume barium suspension. Note the normal position and shape of the small intestinal loops. © 2005 British Small Animal Veterinary Association
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3.9
Ventrodorsal radiograph of a 5-year-old intact Labrador Retriever bitch with lethargy for 3 days, obtained 15 minutes after administration of 13 ml/kg of 20% weight/volume barium suspension. Note the normal position and shape of the small intestinal loops.
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3.10
Survey dorsoventral and post-contrast ventrodorsal (pneumocolonogram) radiographs of 10-year-old female spayed Domestic Short-hair cat with 2-month history of vomiting. On the survey image a caudal left-sided bowel loop (black arrow) was thought to be a dilated small intestinal loop. On the pneumocolonogram the loop is no longer seen on the left side, but the gas-filled descending colon is on the right side. © 2005 British Small Animal Veterinary Association
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3.10
Survey dorsoventral and post-contrast ventrodorsal (pneumocolonogram) radiographs of 10-year-old female spayed Domestic Short-hair cat with 2-month history of vomiting. On the survey image a caudal left-sided bowel loop (black arrow) was thought to be a dilated small intestinal loop. On the pneumocolonogram the loop is no longer seen on the left side, but the gas-filled descending colon is on the right side.
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3.12
Transverse plane ultrasound image of normal stomach of a cat. Measurements of wall thickness should be made in the regions between rugal folds. © 2005 British Small Animal Veterinary Association
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3.12
Transverse plane ultrasound image of normal stomach of a cat. Measurements of wall thickness should be made in the regions between rugal folds.
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3.13
Sagittal plane ultrasound image of normal ileocolic junction of a cat. Arrow indicates the ileum; note the thick outer hyperechoic (darker) muscularis layer. Arrowhead indicates the colon; note the thin walls and barely detectable layering. © 2005 British Small Animal Veterinary Association
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3.13
Sagittal plane ultrasound image of normal ileocolic junction of a cat. Arrow indicates the ileum; note the thick outer hyperechoic (darker) muscularis layer. Arrowhead indicates the colon; note the thin walls and barely detectable layering.
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3.14
Ultrasound image of 12-year-old spayed Golden Retriever bitch with multiple mixed echoic masses in the liver representing metastatic intestinal adenocarcinoma. © 2005 British Small Animal Veterinary Association
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3.14
Ultrasound image of 12-year-old spayed Golden Retriever bitch with multiple mixed echoic masses in the liver representing metastatic intestinal adenocarcinoma.
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3.17
Sagittal plane of liver (L) and falciform fat (F) of an 11-year-old male neutered Domestic Short-hair cat with hepatic lipidosis. © 2005 British Small Animal Veterinary Association
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3.17
Sagittal plane of liver (L) and falciform fat (F) of an 11-year-old male neutered Domestic Short-hair cat with hepatic lipidosis.
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3.18
Ultrasound image of gall bladder in a 13-year-old spayed Cocker Spaniel bitch with cystic mucinous hypertrophy and severely inspissated and gelatinized bile, causing biliary obstruction. © 2005 British Small Animal Veterinary Association
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3.18
Ultrasound image of gall bladder in a 13-year-old spayed Cocker Spaniel bitch with cystic mucinous hypertrophy and severely inspissated and gelatinized bile, causing biliary obstruction.
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3.19
Contrast harmonic ultrasound image of metastatic nodule in a 12-year-old Labrador Retriever with primary splenic haemangiosarcoma. Note hypoechoic irregularly shaped nodules surrounded by normal hyperechoic liver. At this phase of the contrast study, mid-portal perfusion peak, the normal liver is well perfused (and therefore hyperechoic), but the nodules are poorly perfused (hypoechoic). Poor perfusion of a mass or nodule in the liver, during peak perfusion of normal adjacent liver, is the characteristic of malignancy. © 2005 British Small Animal Veterinary Association
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3.19
Contrast harmonic ultrasound image of metastatic nodule in a 12-year-old Labrador Retriever with primary splenic haemangiosarcoma. Note hypoechoic irregularly shaped nodules surrounded by normal hyperechoic liver. At this phase of the contrast study, mid-portal perfusion peak, the normal liver is well perfused (and therefore hyperechoic), but the nodules are poorly perfused (hypoechoic). Poor perfusion of a mass or nodule in the liver, during peak perfusion of normal adjacent liver, is the characteristic of malignancy.
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3.20
Magnetic resonance image (T1 post-contrast) of hypointense poorly enhanced nodules (arrowed) in the liver of a dog with metastatic haemangiosarcoma. © 2005 British Small Animal Veterinary Association
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3.20
Magnetic resonance image (T1 post-contrast) of hypointense poorly enhanced nodules (arrowed) in the liver of a dog with metastatic haemangiosarcoma.
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3.21
Scintigraphic image of 8-month-old male Yorkshire Terrier with solitary extra-hepatic portocaval shunt. Note the small liver with poor radioactivity (*) caudal to the heart (H). © 2005 British Small Animal Veterinary Association
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3.21
Scintigraphic image of 8-month-old male Yorkshire Terrier with solitary extra-hepatic portocaval shunt. Note the small liver with poor radioactivity (*) caudal to the heart (H).
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3.22
Ultrasound image of 11-year-old female spayed Domestic Short-hair cat with diabetes mellitus and 1 day history of vomiting and diarrhoea. Note the hypoechoic pancreas (asterisked) below the cat’s right abdominal wall (arrowed), surrounded by hyperechoic peripancreatic fat (arrowheads). © 2005 British Small Animal Veterinary Association
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3.22
Ultrasound image of 11-year-old female spayed Domestic Short-hair cat with diabetes mellitus and 1 day history of vomiting and diarrhoea. Note the hypoechoic pancreas (asterisked) below the cat’s right abdominal wall (arrowed), surrounded by hyperechoic peripancreatic fat (arrowheads).
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3.23
Ultrasound image of same cat in
Figure 3.22
, obtained after 5 months. The cat had another acute onset of vomiting and incoordination. Note the ill-defined hypoechoic pancreas and hyperechoic peripancreatic fat adjacent to spleen and left kidney. The asterisks mark the dimensions of the width of the pancreas at its thinnest point; the width was 1.25 cm. © 2005 British Small Animal Veterinary Association
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3.23
Ultrasound image of same cat in
Figure 3.22
, obtained after 5 months. The cat had another acute onset of vomiting and incoordination. Note the ill-defined hypoechoic pancreas and hyperechoic peripancreatic fat adjacent to spleen and left kidney. The asterisks mark the dimensions of the width of the pancreas at its thinnest point; the width was 1.25 cm.