radiology packet 34 gi contrast. 5 mo old m golden retriever “remi” hx = presented for...
TRANSCRIPT
Radiology Packet 34
GI Contrast
5 mo old M Golden Retriever“Remi”
• HX = presented for evaluation of vomiting for 7 days
5 mo old M Golden Retriever“Remi”
5 mo old M Golden Retriever“Remi”
• RF
– The stomach is displaced cranially and it contains a small amount of barium.
– Very large barium filled loops of bowel are visible, there are far too many large loops present for this to be all colon.
– Also, the “hairpin turns” and “stacking” of loops is characteristic of small bowel distension.
– The bladder is displaced caudally into the pelvic canal.
• RD
– Small intestinal obstruction
• Next
– Surgery
9 yr old MC DSH “Shadow”
• HX = History of vomiting, anorexia, and weight loss. Survey rads were taken as well as a systematic UGI.
9 yr old MC DSH “Shadow”
9 yr old MC DSH “Shadow”
9 yr old MC DSH “Shadow”
9 yr old MC DSH “Shadow”
9 yr old MC DSH “Shadow”
9 yr old MC DSH “Shadow”
9 yr old MC DSH “Shadow”
• RF– On the survey films there are segments of SI which are dilated beyond normal limits with
fluid and gas.
– Also, there is slight reduction in mid-abdominal detail and spondylosis of L6-7-S1.
– At Time 0 note the normal stomach position.
– At Time 15 minutes the leading edge of the barium column widens and there are irregular filling defects here.
– At Time 30 minutes more of the distal portion of the SI are dilated.
– At Time 45 minutes there is continued dilation of the SI and the point of obstruction is now detected as a tapering, pointed constriction of barium seen in the mid abdomen on the lateral view and along the mid-right abdominal wall on the VD film.
– At time 1.5 hours the obstruction is again evident and one segment of SI is noted to be thickened in the mid-ventral abdomen to the right.
– At time 2 hours the dilated loop of bowel caused by the obstruction is clearly seen from the remaining SI.
• RD– Partial mid-distal small intestine obstruction, most common cause in an older cat is a
neoplastic process such as adenocarcinoma.
13 yr old FS DSH“Spotty”
• HX = thirty day history of vomiting, regurgitation after ingestion of solid food
13 yr old FS DSH“Spotty”
13 yr old FS DSH“Spotty”
• RF– A negative contrast gastrogram was performed and the air outlines a clearly defined opaque
structure in the pyloric antrum.
– The structure does not change position between the 2 views indicating that it is relatively fixed in position.
– There are incidental findings of luxation and degenerative joint disease of the left coxofemoral joint.
– In the VD view a mineral opacity structure is superimposed with the pelvic canal, it is a type of projectile likely from a pellet gun.
• RD– Gastric foreign body
• Next– Surgical removal
11 yr old M Golden Retriever“Bosley”
• Hx = two day history of vomiting, has a history of pica
11 yr old M Golden Retriever“Bosley”
11 yr old M Golden Retriever“Bosley”
11 yr old M Golden Retriever“Bosley”
11 yr old M Golden Retriever“Bosley”
• RF– In the one hour films the pyloric region of the stomach and the descending duodenum have
an abnormal appearance, the bowel lumen is narrow and has a plicated appearance.
– In the VD view there is asymmetrical narrowing of the lumen of the descending duodenum which is often described as an “apple core” lesion.
– The barium outlines granular material in the ascending duodenum.
– In the 1 hr 45 min films there has been some further progression of a small volume of contrast into the jejunum.
• RD– Delayed gastric emptying due to abnormality of the pylorus/descending duodenum
– Most likely these radiographic changes are due to an infiltrative bowel lesion, intestinal adenocarcinoma is the top differential
3 mo old F GSD“Dukey”
• HX = presented for regurgitation
3 mo old F GSD“Dukey”
1 yr old F Newfoundland“Chelsea”
• HX = history of regurgitation and weight loss
1 yr old F Newfoundland“Chelsea”
1 yr old F Newfoundland“Chelsea”
1 yr old F Newfoundland“Chelsea”
1 yr old F Newfoundland“Chelsea”
• RF
– On the lateral view of the survey films there is an air lucency over the cranial mediastinum with a soft tissue opacity ventral to this.
– Also, there is a thin soft tissue structure overlying the caudal vena cava.
– On the VD survey film there is a widened cranial mediastinum and a linear soft tissue structure left of the spine.
– On the esophogram contrast medium outlines and defines an abnormally enlarged esophagus.
• RD
– Megaesophagus
3 mo old F GSD“Dukey”
3 mo old F GSD“Dukey”
• RF
– The lateral survey film of the thorax demonstrated a large air-filled esophageal diverticulum cranial to the heart.
– The trachea was displaced ventrally by the esophagus.
– On the esophogram a large diverticulum was noted cranial to the heart base.
– The diverticulum was created by a focal narrowing of the esophagus just cranial to the carina.
– Also, the contractions in the esophagus distal to the focal narrowing appeared weak.
• RD
– Persistent right aortic arch
• Next
– Surgery