Radiology Packet 32

Gastrointestinal II

15 yr old MC DSH“Puddy”

• HX = two week history of intermittent lethargy and anorexia, one episode of straining to defecate

15 yr old MC DSH“Puddy”

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

8 yr old MC DSH• HX = presented for weight loss, palpation reveals a

possible abdominal mass

8 yr old MC DSH

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

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

7 yr old FS Persian“Princess”

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

1 yr old MC DSH“Bootsie”

• HX = presented for vomiting, anorexia, depression for one day, last night he vomited a penny

1 yr old MC DSH“Bootsie”

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

5 yr old FS DSH“Biddy”

• HX = 2 day history of anorexia and vomiting, she is depressed and dehydrated on physical exam

5 yr old FS DSH“Biddy”

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

5 mo old MC Mixed breed dog“Buster”

• HX = presented for history of vomiting and diarrhea for 4 days

5 mo old MC Mixed breed dog“Buster”

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

3 yr old M Dalmatian“Jake”

• HX = history of several days of vomiting

3 yr old M Dalmatian“Jake”

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

5 mo old F DSH“Marshmello”

• HX = presented because she ate a large screw ½ hour prior to presentation

5 mo old F DSH“Marshmello”

5 mo old F DSH“Marshmello”

5 mo old F DSH“Marshmello”

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