Ch. 47- Small Intestines Flashcards
What could the structures that the arrows are pointing represent?
luminal content (animal was not fasted) or physiologic lacteal dilation.
Linear or not linear FB
Linear
Other than a FB what other things could cause an intestinal obstruction?
Proliferating tissue masses originating within the intestinal
wall include tumors, polyps, and granulomatous infiltrates.
Normal or abnormal finding? (different focal decrease in intestinal luminal diameter post contrast adm.)
Normal finding due to peristalsis
Causes of intussuceptions include:
motility disorders, inflammatory wall lesions,
neoplasia, foreign bodies, or idiopathic causes.
Top Ddx?
Mechanical obstruction
Obstruction or not?
No.
What do you think about the serosal detail in this projection and why?
Serosal margination is adequate even though it appears to be decreased because intestinal segments may be crowded together by an
abdominal mass or when little or no gas is present in the bowel
lumen
The dimensions for the duodenal papilla in dogs are:
mean dimensions of: length 15.2 +/-
3.5-mm, width 6.3+/-1.6-mm, and height 4.3+/-1.0-mm
What’s your ddx?
mechanical obstruction
This is an example of a cat that suffered from chronic ileal obtruction due to intestinal adenocarcinoma.
True or false. If a dog is anemic you should consider taking abd rads to rule out FB of zinc origin.
True
Name the artifact
Ring-down reverberation artifact caused by the gas within the intestinal segment.
Acoustic shadowing artifact occurs
frequently, either with focal luminal gas or with dense particles
of ingesta.
What are some things that may increase the radiopacity within the gi loops?
Clay-based cat litter, small gravel from
dog runs, gastrointestinal medications
that contain calcium, magnesium, aluminum, bismuth, or silicate, and
some pet vitamin and mineral supplements
Radiographic contrast studies of the small bowel can be used to identify the location of the bowel, patency of the lumen,perforation, and irregularities in the contrast medium/mucosal interface. When would a positive contrast study would not be indicated?
when there is
conclusive survey radiographic evidence of bowel obstruction and evidence of free peritoneal gas that is not residual from recent laparotomy, penetrating trauma, or abdominocentesis
In an intussusception, the invaginated portion of the gastrointestinal tract is known as ____. The portion that the invaginated portion invaginates into its lumen is knowns as _____.
intussusceptum
intussuscipiens
What are the canine normal small bowel wall thickness
ultrasound measurements
Dx of this BIPS study?
There is retention and clustering of the BIPS
in the duodenum. This is highly indicative of an obstruction.
BIPS are used mainly for evaluation of gastric dysmotility
and intestinal transit time in the dog and cat.
Extra info: The spheres are
formulated in two diameters: 1.5 mm and 5 mm. The larger spheres are designed to become trapped at the oral aspect of an obstructing lesion, making them suitable for evaluation of partial and complete obstruction
partial and complete obstruction
How many peristaltic waves per min are usually seen in the small intestine?
1-3/min
What is the most frequent cause for a
nondiagnostic barium study?
Failure to administer an adequate volume
of contrast medium.
In the adult
dog, the normal length of the jejunal lymph nodes ranges from: ________. What about in puppies?
adults: 5 to 200 mm
puppies: 1.5-12.5 mm ( are very prominent and hypoechoic)
the ileocolic
junction in the cat has the appearance of:
a wagon wheel
flower (dr moon)
cat butt ( dr cole)
What is the recommended dose for a braium sulfate study for dogs and cats?
The roentgen signs
assessment for the small intestine are:
Margination: serosal surface definition
Size: diameter of lumen and/or serosa-to-serosa
Position: location within abdominal cavity
Shape: contour of bowel loops
Radiopacity: lumen contents and bowel wall
Architecture: mucosa/bowel wall smoothness
Motility: intermittent narrowing of contractions
What are the layers of the intestinal wall and their echogenicity?
lumen- hyperechoic
mucosa- hypoechoic
submucosa- hyperechoic
muscularis- hypoechoic
serosa- hyperechoic
Where is the duodenal papilla typically located?
The
major duodenal papilla is immediately adjacent to the right
limb of the pancreas.
Is this FB within the colon? If you are unsure what can u do to confirm where it is?
No most likely it’s not in the colon
if unsure do a pneumocolonogram
Why there is a routine acquisition of three views when evaluating the gastrointestinal tract?
To take advantage of the redistribution of intraluminal gas.
What are the canine and feline small bowel normal
radiographic measurements?
What is your top ddx for this radiographic finding?
Pseudoulcers.
this is a normal finding caused by mucosal depressions on the antimesenteric wall over submucosal
lymphoid accumulations
What is the most thickest intestinal segment in the dog? and in the cat?
dog- duodenum
cat- ileum
Top ddx?
Ileocolic intussuception
Less likely gastric FB
The
appearance of mechanically obstructed bowel differs from
functionally obstructed bowel by the following parameters:
1) mechanically obstructed bowel is usually of larger diameter than functionally obstructed bowel
2) both gas and fluid are typically in the lumen of mechanically obstructed bowel, whereas functionally obstructed bowel tends to contain more gas or may be completely gas filled
3) patients with mechanical
obstruction usually have some bowel segments of normal size,whereas patients with functional obstruction may have generalized involvement of the bowel.
disclaimer: it will rarely be this easy, these usually overlap.
Dog’s vomiting. What’s your main radiographic interpretation and what would you do next?
Dilation of stomach with fluid and gas. Take a left lateral rad and if you don’t see anything either abd ultrasound or keep the dog in lateral recumbency for a couple of min and retake left lateral.
Acute duodenal obstruction is harder to dx than chronic (we read this in the previous ch)
MC place for intussusceptions to happen?
ileocolic junction or cecocolic but can occur anywhere
What’s ur dx?
Pneumoperitoneum most likely due to GI perforation.
Eventhough a FB is not seen there are some radiopaque materials (such as rare earth magnet, aluminum etc) that may cause a mechanical obstruction and the actual FB will never be seen on rads.
Size of feline duodenal papilla
ranges from
2.9 to 5.5 mm wide and averages 4.0 mm in height when
imaged in the transverse plane
Why ionic
iodinated contrast media are not recommended for oral
administration in young and debilitated and dehydrated patients?
because the resultant fluid shift can worsen
any hypovolemic state.
For a BIPS study, the spheres are given with a meal. True or False: The type of meal influences gastric emptying.
True
Linear or not linear FB
Linear.
Look at the distal small intestinal seg ventral to the L spine they are stacked
In cats, the normal lymph node size guidelines are:
pancreaticoduodenal length (L) 8.4 mm (6.6 to 13), diameter
(D) 4.6 mm (3.6 to 6.2); jejunal L 20.1 mm (11.4 to 39.0),
D 5.0 mm (2.8 to 7.2); and ileocecal L 11.8 mm (6.7 to 23.2),
D 4.1 mm (2.7 to 4.8)
What are the feline small bowel normal ultrasound measurements?
For a contrast study with barium what is the time sequence for taking the radiographs?
Immediate
15 minutes
30 minutes
1 hour
2 hours
4 hours
can keep taking rads until barium is gone (not ideal obviously cause u will be there forever)
