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THRALL - Thom > 40 - Liver and Spleen > Flashcards

40 - Liver and Spleen Flashcards

1
Q

What objective measure of liver size can be used radiographically? What are reported normal values?

A

Liver length (caudoventral extremity to caudal VC) vs length of T11

Normal; 5.4-5.5 x
Brachy: 5.16x
Pekingese: 4.64x

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2
Q

Name 6 nonpathological causes for caudal extension of the liver (beyond costal arch)

A

Deep inspiration / thoracic overexpansion
Laxity of triangular lig. in older animals
Pendulous abdomen
Obesity (less dorsal extension)
Conformation (brachys / chondrodystrophics)
Young animals - larger liver relative to body size

-> Should see blunting to dx hepatomegaly

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3
Q

Mineralisation of the gallbladder wall has been associated with which three diseases?

A

Gallbladder carcinoma, cholecystitis, cystic mucinous hyperplasia

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4
Q

List 6 causes of focal hepatic mineralisation

A 
Haematoma
Echinococcus
Granuloma
Hepatic necrosis
Neoplasia
Abscess
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5
Q

List 5 causes of portal gas accumulation

A 
Necrotizing gastritis / enteritis
GI Trauma
GI ulceration
GI distension
Interventional procedures

-> Similar to air bronchograms

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6
Q

Describe the progression of gas accumulation in emphysematous cholecystitis

A

In wall -> filling gallbladder lumen (24-28hrs) -> In pericholecystic tissues

-> Obstruction of cystic duct may predispose

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7
Q

List two EXPECTED causes of gas accumulation in biliary system

A

Duodenal / biliary surgery

Incidental reflux in cats (incompetence of sphincter of Oddi)

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8
Q

List 4 causes of hepatic abscesses

A

Necrotic tumours
Adjacent infection (e.g. pancreatic)
Penetration wounds
Ascending portal infection

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9
Q

List 4 most common EHPSS (according to Thrall!)

A

Spleno-phrenic
Spleno-caval
Right gastro-caval
Right gastro-caval with caudal loop

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10
Q

What is the normal gallbladder volume in the dog and cat?

A

1ml/kg or less in dogs

2.4ml in cats

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11
Q

What is the normal thickness of the gallbladder wall in the dog and cat?

A

Cat: <1mm

Dog 1-2mm

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12
Q

What is the normal diameter of the CBD in the dog and cat?

A

Cat: up to and including 4mm
Dog: up to and including 3mm

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13
Q

List 6 causes of hyperechoic liver

A 
Vacuolar hepatopathy (Hepatic lipidosis /steriod hepatopathy)
Chronic hepatitis
Lymphoma
Amyloidosis
Cholangiohepatitis
\+- MCT
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14
Q

List 6 causes of hypoechoic liver

A 
Acute suppurative hepatitis
Lymphoma
Leukaemia
Amyloidosis
Congestion
Cholangiohepatitis
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15
Q

List 4 primary hepatic tumours

A

Hepatocellular carcinoma (1st most common)
Cholangiocarcinoma (2nd)
Haemangiosarcoma
Neuroendocrine tumour

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16
Q

What is the most common hepatic malignancy in the dog?

A

Metastatic neoplasia! 2.5x more likely than 1ry neoplasia

Most commonly: Spleen, GIT and pancreas

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17
Q

What is the most common 1ry hepatic neoplasia in the cat?

And what is the most common hepatic malignancy?

A

Biliary cystadenoma = most common 1ry neoplasia

Cholangiocarcinoma = most common malignancy

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18
Q

What CEUS features of benign vs malignant hepatic nodular disease are describe?

A

Benign - iso to liver at peak normal liver perfusion

Malignant - hypo

19
Q

What US features are described with hepatocutaneous syndrome (superficial necrolytic dermatitis)?

A

Honeycomb appearance (hypo nodules with hyper surrounding parenchyma)

20
Q

Describe approximate US progression of haematomas

A

Hyper -> Hypo/an -> hyper (reorganisation / mineralisation)

21
Q

What feature of the GB has been associated with a 70Sn and 100% sp for bactibilia and bacterial cholecystitis?

A

Immobile gallbladder sludge

22
Q

Cystic mucinous hyperplasia has been linked to which disease?

A

Gallbladder mucocoele

23
Q

List 5 causes of gallbladder wall oedema

A 
R CHF
Anaphylaxis
Hypoproteinaemia
Portal hypertension
Sepsis
24
Q

What percentage of dogs have mobile GB sludge?

A

53% asymptomatic

35-48% of ALL dogs

25
How do you calculate the volume of GB / urinary bladder ?
width x height x length X 0.52 (ml?)
26
What two objective measures are used to demonstrate normal GB motility?
Reduction in volume 60 / 120mins post feeding: By 25% OR to <1ml/kg
27
What is the incidence of loss of GB wall integrity / rupture in mucocoele?
50%
28
List 3 US features associated with GB rupture
Discontinuity of wall Bright pericholecystic fat Pericholecystic fluid
29
Which endocrinopathy is associated with GB mucocoele?
HyperA
30
Define the timeline for the US appearance of progressive biliary obstruction
GB and cystic duct dilation - 24 hours CBD dilation (progressive) - 48hrs Hepatic duct dilation - 3-4 days Lobar and interlobar duct dilation - 7 days
31
What % of cats with EH obstruction had gallbladder dilation? What is a more reliable feature (and what % have this)?
43% GB dilation | Bile duct dilation more reliable - 97%
32
What is the normal ratio of PV: VC? And what is seen in PSS?
0.7-1.25 normal | <0.65 PSS
33
Name 2 sites the acquired EHPSS are commonly located
Medial to spleen | Medial to L kidney
34
Which intrahepatic shunt may represent patent ductus venosus?
Left divisional
35
In which radiographic projection does the distal splenic extremity tend to be most conspicuous?
Right lateral
36
In a study of 100 cats, how frequently was the distal extremity of the spleen visualised in lateral radiographis?
1! Very rare! | If seen = splenomegaly
37
What feature of the feline spleen makes it less able to enlarge? What are the two most common causes of feline splenomegaly?
Non-sinusoidal. Cannot store large volumes of blood Lymphoma and MCT
38
What is the most common neoplasia of the canine spleen? And what are the 2 most common lesions of the canine spleen?
HSA | Haematoma and hyperplasia
39
What are normal splenic measurements in the cat?
Transverse thickness Different studies: Height = 7.1mm (5.1-9.1mm) Height 8.2mm (5.3-11.1mm)
40
Splenomegaly without change in echogenicity has been described with which 2 anaesthetic agents?
Phenothiazines | Pentobarbital
41
Name 5 features that have been described in splenic torsion on US
Splenomegaly "Lacy" apperanance - hypo parenchyma with hyperechoic lines Dilated splenic veins with intravascular thrombi Lack of flow Hyperechoic hilar triangle Gas within parenchyma
42
Name 5 diffuse infiltrative neoplasms of the spleen
``` Lymphoma Leukaemia Malignant histiocytosis MCT Multiple myeloma ```
43
Name a fungal cause of splenitis in the cat!
Histoplasmosis

THRALL - Thom (40 decks)

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