Lecture 1 Abdomen Flashcards
Preparation for abd rads
Elective sx
Fast 8-12 hours
Empy bowels and bladder if possible
performing exam
Low to medium kVp (60-80)
Maximize contrast betwe
If patient more than 10 cm thick use grid
Try to expose on expiration (cause unstructured interstitial patter in Dorso-caudal….)
Collimate to reduce scatter
DV
Worthless except in bloat to find stomach
Interpretation paradigm
- Extra abdominal structures and assess body condition
- osseous structures
- diaphragm
- thorax
- pelvis
- pelvic limbs
- soft tissue
- Peritoneum and Retroperitoneum
- GI, Spleen, Liver, Pancreas
- GU, Adrenals, LN
Kidney that is hard to see
Right kidney
Pyloric part of stomach…tidbit
Gas often seen in pyloric portion of the stomach (right sided structure) on L lat rad
- If there is a concern about pyloric outflow do Left lateral rad
Abdominal structures not expected to see
Adrenal glands
Lymph nodes
Pancreas and ducts
Gallbladder and biliary ducts
Ovaries, Uterus, Ureters (unless calculi)
Abdominal aorta
Dog vs Cat
Cats
- large puddles of fat (falcifarm ligament)
- puddle of fat caudo-dorsal peritoneum
Dogs
- fat in caudo-dorsal peritoneum
consequence of obesity
Decreased serosal detail due to secondary scatter radiation
Extra-abdominal structures
Osseous structures
Vertebrae (thoracic, lumbar)
- Look for aggressive lesions in spine…
Ribs
Sacrum
Intervertebral disc spaces
kidney fake-out
Left and right kidney => summation => looks like soft tissue mass effect
Serosal detail def.
Decreased serosal detail
Contrast we normally see between soft tissue and fat of abdomen
Decreased serosal detail
- fat: scatter radiation
- skinny
- young dogs and cats: some abdominal fluid normal
- pendulous abdomen
Air in peritoneal space
Air increases serosal detail
Surgical emergency if origin unknown
Retroperitoneal
stuff above the imaginary line in the abdomen
Peritoneal
Stuff below imaginary line
Peritoneal / retroperitoneal detail
- Neonate (up to 6mo), athletic or cachectic = no detail
- Normal animal = good detail
- Mildly to moderately obese = excellent detail
- Extreme obesity = decreased detail (scatter radiation)
Mass effect
Implies loss of sersoal detail and/or displacement of specific abdominal organs away from where a mass could reside
Pneumoretroperitoneum always an…
Extension of a pneumomediastinum
Pneumoperitoneum
Hollow viscus rupture or penetrating wound (including recent sx)
Takes 28 days to resolve post-op
Focal or multifocal peritoneal mineralization
Cholesterol inclusion cysts
Dystrophic mineralization of any structure
- secondary to prior inflammation
Vessel mineralization
- usually associated with endocrinopathies or chronic uremia
Aged cats => adrenal glads
Hepatomegaly
- Rounded caudoventral margin
- Caudal shift of gastric axis
- Margins extend beyond the costal arches (also happens on ispiration)
- Caudal displacement of cranial abdominal organs (right kidney)
Microhepatia
- Caudoventral margin not seen
- Cranial shift of gastric axis
- Calculi present
- struvites
- calcium oxalates
- Cranial displacement of organs of abdomen
- Renomegaly with PSS
- Rule out PPDH (Peritoneal Pericardial Diaphragmatic hernia)
Microhepatia ddx
chronic hepatitis with hepatic cirrhosis
portosystemic shunt
Hepatomegaly ddx
Hepatic lipidosis (cats)
cushings
diabetes mellitus
tox
viral hepatitis
hepatic cirrhosis
Splenomegaly
Hemangiosarcoma / mass (dogs)
Tranquilization
Lymphoma (cats)
- round cell tumors
Torsion
Vascular compromise
- portal venous thrombosis
