Radiology Package 31

Gastrointestinal

5-month old puppy• Hx: Possible ingestion of a sewing needle

5-month old puppy

• RF– A sewing needle is present within the body of the stomach which also

contains a large amount of ingesta.

– Small bone fragments are present within the stomach and in other portions of the GI tract.

• RD– Gastric needle foreign body

• Next– Radiograph prior to surgery to see if the needle has moved to colon or

has passed.

11-year old Boston Terrier“Leigh”

• Hx: Presented with chronic vomiting. The vomiting has recently increased in frequency.

11-year old Boston Terrier“Leigh”

• RF– There is a rounded soft-tissue opacity structure with several areas of

mineral opacity in the cranial abdomen, caudal to the liver. This is a fluid filled stomach.

– The mineral material is bone or similar material.

– The small intestinal loops are fluid-filled and some are at upper limits of normal to mildly enlarged.

– There is an incidental finding of IVD space collapse at T12-13 and minor spondylosis and T12-13 through L1-2.

• RD– Gastric obstruction – likely chronic

– Mild small intestinal destruction

5-month old mixed breed dog“Buster”

• RF– Nearly all of the small intestinal loops are fluid and gas distended.– The stomach is pushed cranially by the dilated SI.– The liver is mildly enlarged, extending beyond the costal arch and the caudal border

is rounded.

• RD– Generalized distended SI

• R/O– Distal bowel obstruction– Physiological ileus – Infective process (eg. Parvo virus)

• Next– CBC, parvo stool test.– Upper GI study would differentiate physiological ileus from mechanical obstruction.

5-year old FS Shetland Sheepdog“Sophie”

• Hx: Has been vomiting for one day. Her owner thinks Sophie may have eaten a bone when she got into the garbage yesterday. PE is unremarkable.

5-year old FS Shetland Sheepdog“Sophie”

• RF– A cortical bone fragment is found within the fundus of the stomach and is best

seen on the VD view.– The colon is entirely filled with feces which are not well formed indicating

possible diarrhea.– The SI are felt to be within normal limits although they contain various amounts

of gas and a few segments of bowel are a bit dilated.

• RD– Gastric bone foreign body– Possible enteritis

• Next– Repeat radiographs within 12-24 hours to see if bone has dissolved or passed.– Surgery

Young Standard Poodle

• Hx: Presented recumbent with massive abdominal distension.

Young Standard Poodle

• RF– Marked gas dilation of the stomach.

– Pylorus is displaced dorsally and cranial to the body and fundus.

– Compartmentalization of stomach is present.

– Gas noted in the esophagus.

• RD– Gastric dilatation volvulus

• Next– Surgery

9-year old Standard Poodle“Bosen’s Mate”

• Hx: Presented with massive abdominal distension and pain.

9-year old Standard Poodle“Bosen’s Mate”

• RF– Massive gastric dilation with gas and food.

– The pylorus appears to be on the right side.

– Compartmentalization is lacking.

• RD– Massive gastric dilation.

8-year old English Springer Spaniel“Ginger”

• Hx: Presented with vomiting. She is very depressed and weak. She is febrile and has harsh lung sounds.

8-year old English Springer Spaniel“Ginger”

• RF– Depression of the trachea.

– Soft tissue linear structures overlying the dorsal lung on the lateral view.

– Air bronchograms in the ventral lungs.

– Pulmonary infiltrates in the right cranial and middle lung lobes, lobar fissure noted.

– Increased soft tissue opacity in the caudal mediastinal region on the VD view.

• RD– Megaesophagus and right cranial and middle aspiration pneumonia.

4-month old Great Dane“Columbo”

• Hx: Presented because of vomiting for several days. There may be a history of regurgitation.

4-month old Great Dane“Columbo”

• RF– Depressed trachea and heart.

– Increased soft tissue opacity of dorsal thorax.

– One soft tissue band is noted in the caudodorsal thorax just below the aorta, another is faintly seen as a continuation of the caudal vena cava across the diaphragm/liver shadow.

– Cranial mediastinum is wide.

– The trachea is laterally displaced to the right.

• RD– Megaesophagus

11-year old FS Shar Pei“Soo Ling”

• Hx: Presented with vomiting. A possible mass within the cranial abdomen is palpated.

11-year old FS Shar Pei“Soo Ling”

• RF– Large soft tissue and gas opacity in region of stomach with flecks of mineral noted. – The duodenum is air filled and slightly larger than normal.– The stomach is massively distended with fluid and gas.– Mineralized and dilated bronchi.– Mineralized costal-rib articulation is present.

• RD– Gastric distension

• R/O– Pyloric outflow obstruction

• Neoplasia• Foreign body• Hypertrophy or inflammation

– Gastric atony, or reduced tone

• Next– Ultrasound– Gastrogram– Fluoroscopy to observe gastric motility– Exploratory

8-year old MC DSH

• Hx: Presented for weight loss. Palpation reveals a possible abdominal mass.

8-year old MC DSH• RF

– The stomach is visible as a collapsed soft-tissue structure.– Microhepatia.– Both kidneys are considered small.– A large, irregular soft-tissue mass is present in the left cranioventral abdomen. There is a tubular gas

shadow within the mass. Mineral material is present within the mass in close association with the gas shadow.

– The mass displaces the colon to the right.– SI loops are fluid-filled and some are mildly distended.– There is focal loss of abdominal detail in the right cranial to mid abdomen.

• RD

– Abdominal mass– Free abdominal fluid (small volume) is suspected

• R/O– Lymphosarcoma– Adenocarcinoma

• Next– Abdominal ultrasound and guided fine needle aspiration

6-year old Siamese cat“Caeser”

• Hx: Presented with a history of chronic vomiting.

6-year old Siamese cat“Caeser”

• RF– Both kidneys are small.– There is mineralization in the pelvic region of both kidneys.– The stomach is enlarged but not distended because the folding of the stomach

wall is visible.– There is a mineral opacity outlining the stomach wall. – The visible lung shows a diffuse nodular interstitial lung pattern.

• RD– Bilaterally small kidneys– Bilateral renal pelvic mineralization– Gastric wall mineralization with enlargement

• R/O– Mineralization of the gastric wall secondary to renal insufficiency (uremic

gastritis).– Feline asthma with mineralization secondary to uremia.

10-year old Chihuahua“Tia”

• Hx: Ingested a rawhide chew 2 hours ago. Has been vomiting ever since.

10-year old Chihuahua“Tia”

• RF– There is a mild interstitial lung pattern present that is consistent with

normal aging change.

– There is an ill-defined area of soft tissue opacity in the caudodorsal thoracic cavity in the region of the caudal esophagus. Gas accumulation is visible in the esophagus cranial to the soft tissue opacity.

– Evaluation of the VD view shows normal lung tissue in this region.

– The stomach is mildly distended with gas.

• RD– Esophageal foreign body.