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Diagnostic Imaging > Gastrointestinal Tract > Flashcards

Gastrointestinal Tract Flashcards

1
Q

Normal stomach anatomy:

A
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2
Q

What is highlighted in this stomach? What other structure is seen?

A

fundus

accumulation of gas outlines rugal folds

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3
Q

What is highlighted in this stomach? In what projection is it better visualized?

A

gastric body

VD - gas is not gravity dependent

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4
Q

What is highlighted in this stomach?

A

pylorus

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5
Q

What is the normal anatomy of the stomach on the left lateral projection?

A
  • fundus dependent (down) = fluid-filled
  • pylorus and proximal duodenum non-dependent (up) = gas-filled
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6
Q

What is the normal anatomy of the stomach on the right lateral projection?

A
  • pylorus dependent (down) = fluid-filled
  • fundus non-dependent (up) = gas filled
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7
Q

What is a pyloric pseudomass? How can it be ruled out?

A

seen on right lateral projection when the pylorus is fluid-dilled and resembles a mass

take a left lateral and VD radiograph, where it will be gas-filled

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8
Q

How does the normal feline stomach compare to canines?

A

slightly to the left of midline with the pylorus slightly to the right on VD

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9
Q

How does the small intestine position differ in felines?

A

lack of segments within the left abdomen due to increased fat deposits

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10
Q

What is being pointed to in this radiograph?

A

wet hair artifact - likely due to a previous ultrasound

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11
Q

What is being pointed to in this radiograph? How is it comfirmed?

A

normal fat within gastric submucosa that can resemble a FB, best seen on an empty stomach

  • CT = hypoattenuated fat
  • U/S = hyperechoic
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12
Q

What is the normal size of the canine small intestine?

A

< 1.4x height of L5

< 2x minimal small intestinal diameter

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13
Q

When is the canine small intestine considered dilated? When is mechanical obstruction of high concern?

A

1.4-2.4x height of L5, 2-3.4x minimal small intestinal diameter

> 2.4x height of L5, >3.4x minimal small intestinal diameter

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14
Q

What is the normal size of the feline small intestine? In what way is it different than canines?

A

12 mm in width from serosa to serosa

  • very little gas - not as aerophagic as dogs
  • lack of size variation in felines makes ratios not necessary
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15
Q

What unique feature of the feline small intestine is observable on radiographs?

A

normal segmentation and peristalsis = “string of pearls”

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16
Q

Are obstructions common in the colon?

A

no - if an FB made it this far, it will likely be excreted with feces

  • contrast studies help with observation
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17
Q

What positive contrasts are commonly used for colon studies? What are the 2 indications for performing this?

A

barium and iodine —> radioopaque

  1. vomiting
  2. suspected dysmotility
18
Q

What are 2 contraindications for performing positive contrast used for colon studies?

A
  1. intractable vomiting - aspiration risk
  2. possible GI rupture
19
Q

What are 2 negative contrasts used for colon studies?

A
  1. room air - readily available and safe
  2. CO2 - more commonly used for urinary tract
20
Q

What are 5 uses of contrast studies?

A
  1. can more accurately view mucosal surface
  2. allows evaluation of GIT wall
  3. visualized motility
  4. locates regions of GIT
  5. located obstructions
21
Q

What is occurring in this radiograph?

A

double contrast gastrogram - barium + air

  • lack of positive contrast in fundus, likely due to some kind of FB (intraluminal filling defect)
  • can observe normal striation of feline esophagus
  • can observe normal rugal folds in the pylorus
22
Q

Feline upper GI study:

A
  • normal gastric filling with positive contrast
  • normal string of pearls = peristalsis
23
Q

What 2 specific large intestinal contrast studies are performed?

A
  1. pneumocolon - sedation, delineates path of colon to rule in/out gas dilation of small intestine on survery radiographs
  2. barium enema - heavy sedation or GA, barium sulfate suspension through Foley catheter and enema bag
24
Q

Pneumocolon:

A

room air differentiates it from small intestine

25
Q

What is the primary differential for vomiting patients?

A

GIT obstruction - animals love to eat things they shouldn’t!

26
Q

Normal canine stomach:

A

LL = fluid in fundus, gas in pylorus

RL = fluid in pylorus, gas in fundus

27
Q

What is mechanical ileus? What is the most common cause?

A

FOCAL - dilation of a segment of the GIT

obstructions of the GIT - luminal, mural, extra-mural

28
Q

What is functional ileus? What is the most common cause?

A

GENERALIZED - more mild dilation of the entire GIT

GIT paralysis or decreased motility caused by infection, inflammation or toxins

29
Q

GIT, Roentgen signs:

A
30
Q

What Roentgen signs are associated with distension of the GIT? Mechanical vs functional ileus?

A

SIZE - anatomy, measure diameter, use ratios
SHAPE - relaxed, hairpin turns, stacking, plication

LOCATION - segments affected
NUMBER - amount of segments affected

31
Q

What are the 3 major etiologies of mechanical obstruction?

A
  1. LUMINAL - FB, intussusception
  2. MURAL - neoplasia, infection, inflammation, stricture
  3. EXTRA-MURAL - infarction, intestinal volvulus, external compression
32
Q

What is pyloric outflow obstruction? What are 3 common causes?

A

mechanical obstruction of the stomach leading to gastric distention

  1. luminal FB
  2. hypertrophic gastropathy (mural) common in small breeds
  3. mural neoplasia
33
Q

What is likely occurring in this radiograph?

A
  • stomach full and extending beyond the 13th ribs
  • contraction at pylorus with thickened walls
  • no contrast beyond the contraction = decreased outflow

PYLORIC OUTFLOW OBSTRUCTION

34
Q

What are the 3 radiographic signs of gastric dilatation volvulus? What is a common secondary sign?

A
  1. craniodorsal displacement of pylorus over fundus
  2. ventral displacement of fundus
  3. compartmentalization = soft tissue band caused by folding of gastric wall between the 2 gas-distended stomach compartments

vascular congestion = splenomegaly

35
Q

What is considered the gray zone of segmental intestinal dilation?

A

1.4-2.4x height of L5

between 2-3.4x minimum small intestinal diameter

  • need further testing, like repeated radiographs or U/S
36
Q

What are the 2 populations of small bowels with mechanical obstruction?

A
  1. distended portion orad to obstruction
  2. normal small intesting aborad to obstruction
37
Q

What is seen in this contrast study?

A

normal aborad movement of contrast until it abruptly stops at a dilated segment, creating concave a filling defect indicative of a luminal, round FB

38
Q

What is seen in these radiographs?

A

all of intestine is uniformly dilated with no indication of peristalsis = functional ileus

39
Q

What is megacolon? How is it differentiated?

A

functional disease common in cats, causing the development of a feces-filled colon

  • NORMAL = <1.28x length of L5
  • MEGACOLON = >1.68x length of L5
  • CONSTIPATION = 1.48x length of L5
40
Q

What is colonic torsion?

A

colon twists around its longitudinal axis, causing severe dilation and mal-positioning of the colon

  • surgical emergency
  • common in dogs
41
Q

How do patients with linear foreign bodies typically present? What is seen on their radiographs?

A

vomiting, anorexia, abdominal pain

NOT CLASSICAL SIGNS OF MECHANICAL ILEUS
- no dilation
- tortuous, irregular margins
- abrupt changes in direction
- plication: focally gathered/bunched

42
Q

Where are linear foreign bodies most commonly anchored?

A
  • CATS = base of tongue
  • DOGS = pylorus

Diagnostic Imaging (27 decks)

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