Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of...
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Transcript of Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of...
![Page 1: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/1.jpg)
Radiology Packet 32
Gastrointestinal II
![Page 2: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/2.jpg)
15 yr old MC DSH“Puddy”
• HX = two week history of intermittent lethargy and anorexia, one episode of straining to defecate
![Page 3: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/3.jpg)
15 yr old MC DSH“Puddy”
![Page 4: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/4.jpg)
15 yr old MC DSH“Puddy”
• RF– Both kidneys are small and irregularly shaped with the left being smaller than the
right.– Multiple foci of mineralization are present in the renal pelvises bilaterally.– The colon contains a large amount of formed and solid appearing granular
material and is at the upper limit of normal diameter in some areas.– Spondylosis is present at L6-7 and metallic structures are present in the inguinal
ring.
• RD– Chronic renal disease– Constipation/obstipation is present
![Page 5: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/5.jpg)
8 yr old MC DSH• HX = presented for weight loss, palpation reveals a
possible abdominal mass
![Page 6: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/6.jpg)
8 yr old MC DSH
![Page 7: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/7.jpg)
8 yr old MC DSH• RF
– The stomach is visible in both views as a collapsed soft-tissue structure.
– In the lateral view the stomach is cranially displaced and the liver is well within the costal arch.
– Both kidneys are considered small.
– A large, irregular soft-tissue mass is present in the left cranioventral abdomen and in both views there is a tubular gas shadow within the mass.
– Mineral material is present within the mass and the mass is displacing the colon to the right.
– Small intestinal loops are fluid-filled and some are mildly distended.
– There is focal loss of abdominal detail in the right cranial to mid abdomen in the VD and in the cranioventral abdomen in the lateral view.
• RD– Abdominal mass
– Free abdominal fluid
• Next– Ultrasound and biopsy
![Page 8: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/8.jpg)
7 yr old FS Persian“Princess”
• HX = the owner notices she is spending a lot of time in her litterbox, she is straining but has not passed stool in 4 days
![Page 9: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/9.jpg)
7 yr old FS Persian“Princess”
![Page 10: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/10.jpg)
7 yr old FS Persian“Princess”
• RF– There is a large amount of solid-appearing fecal material in the colon that completely fills the
colon.
– The colon is approximately 2 times the length of L7 vertebral body.
– A faint focal area of increased opacity seen ventral to L6 in the lateral view may be a “Bate’s Floater” which are necrotic fat bodies that undergo mineralization and are an incidental finding.
– The kidneys are normal in size and shape.
– The spleen is visible along the left lateral body wall and is normal.
• RD– Megacolon
• Next– Surgical Resection
– Enema if not too severe
![Page 11: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/11.jpg)
1 yr old MC DSH“Bootsie”
• HX = presented for vomiting, anorexia, depression for one day, last night he vomited a penny
![Page 12: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/12.jpg)
1 yr old MC DSH“Bootsie”
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1 yr old MC DSH“Bootsie”
• RF– A rectangular shaped mineral structure is present within the mid-abdomen, near midline at
the level of L2.
– Small intestines are mostly fluid filled, larger than normal diameter, and appear to be bunched centrally.
– On the VD view the SI appear corrugated along the right body wall.
– The stomach has an abnormal appearance on the lateral view, being a bit displaced caudally and elevated it contains many air bubbles.
• RD– Enlarged small intestine, possible linear foreign body
– Small intestine mineral foreign body
– Possible low-grade ascites
• Next– Ultrasound
– Surgical exploratory
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5 yr old FS DSH“Biddy”
• HX = 2 day history of anorexia and vomiting, she is depressed and dehydrated on physical exam
![Page 15: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/15.jpg)
5 yr old FS DSH“Biddy”
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5 yr old FS DSH“Biddy”
• RF– Gas distended stomach.
– Gas and fluid dilated SI, larger diameter than normal.
– There is a back and forth bowel pattern, plication.
– This plicated region is the duodenum on both views.
– There is a transitional lumbosacral segment and spondylosis of this region.
– Mild DJD of the hips.
• RD– Linear foreign body within the proximal small intestine
– Possible gastric foreign body
• Next– Surgery
![Page 17: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/17.jpg)
5 mo old MC Mixed breed dog“Buster”
• HX = presented for history of vomiting and diarrhea for 4 days
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5 mo old MC Mixed breed dog“Buster”
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5 mo old MC Mixed breed dog“Buster”
• RF– Nearly all of the small intestinal loops are fluid and gas distended beyond normal limits.
– The colon is difficult to follow, regardless there are too many loops of distended bowel to be accounted for solely by the colon.
– The stomach appears to be pushed cranially by the dilated SI.
– The liver is mildly enlarged, extending beyond the costal arch.
• RD– Generalized distended SI
• Next– CBC
– Parvo stool test
– Abdominal ultrasound
![Page 20: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/20.jpg)
3 yr old M Dalmatian“Jake”
• HX = history of several days of vomiting
![Page 21: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/21.jpg)
3 yr old M Dalmatian“Jake”
![Page 22: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/22.jpg)
3 yr old M Dalmatian“Jake”
• RF– Gas distended loops of small intestine.– Plicated appearance of some of these SI loops.– Some SI loops contain “fecal-like” material, seen on both the VD and lateral
views.
• RD– Partial SI obstruction
• Next– Surgery
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5 mo old F DSH“Marshmello”
• HX = presented because she ate a large screw ½ hour prior to presentation
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5 mo old F DSH“Marshmello”
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5 mo old F DSH“Marshmello”
![Page 26: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/26.jpg)
5 mo old F DSH“Marshmello”
![Page 27: Radiology Packet 32 Gastrointestinal II. 15 yr old MC DSH “Puddy” HX = two week history of intermittent lethargy and anorexia, one episode of straining.](https://reader036.fdocuments.us/reader036/viewer/2022081603/56649e9d5503460f94b9d8d1/html5/thumbnails/27.jpg)
5 mo old F DSH“Marshmello”
• RF
– Large metallic foreign body in an otherwise ingesta filled stomach
– Previously noted gastric foreign body is now in the small intestine, no evidence of dilation is seen.
– Previously noted foreign body is now in the descending colon at the pelvic inlet.
• RD
– Gastric foreign body that passed normally through GI tract
• Next
– Monitor feces for passage, if not seen repeat radiographs