Liver, Gallbladder, and Spleen Flashcards
When do you use ultrasound for the Liver, Gallbladder or Spleen?
large accumulations of peritoneal fluid or those patients without larger fat stores (Cachexia or young patients)
When do you use radiographs for the Liver, Gallbladder or Spleen?
In patients with a lot of gastrointestinal tract gas, food in the gastrointestinal tract or peritoneal gas
What is the enemy of ultrasound?
AIR
If disease is suspected and no radiographic or ultrasonographic changes found, what then?
Biopsy
How many lobes do dogs and cats have for their liver?
6 lobes and 2 processes
What lobes of the liver are visible on radiographs?
the lobe that points caudoventrally on the lateral projection
Left lateral in the dog
Right Lateral lobe in the cat
What should the gastric axis be parallel with?
The Ribs
What should the gastric axis be perpendicular with?
the Spine
What are the Differential Diagnoses for a cranial displacement of the gastric axis?
Diaphragmatic hernia
Ascites
Pregnancy
The Liver is small
What are the DIfferential Diagnoses for a caudal displacement of the gastric axis?
Hepatomegaly
Inguinal Hernia
Pleural effusion
tension pneumothorax
If the liver is enlarged….
May displace gastric axis caudally
May extend past costal arch
Pylorus may move medially on VD
Increased soft tissue opacity cranially
If the Liver is small…
Gastric axis is cranially displaced
Reduced soft tissue opacity cranial abdomen
What causes the Liver to appear enlarged due to the lungs?
Lungs are over-inflated due to dyspnea and pleural effusion
If the margins of the liver are triangular or slightly rounded then consider what?
Endocrine disorders:
Diabetes mellitus resulting in hepatic lipidosis
Hyperadrenocorticism
Microhepatia
Reduction in liver size
What are the differential diagnoses for Microhepatia?
Liver shunting
Chronic hepatitis
Cirrhosis
Diaphragmatic hermia
Portal Systemic Shunt
Shunt from portal vein to CVC or azygous vein
bypasses the liver
What side is Intrahepatic PSS more common on?
Left side
What modality do you use to see PSS?
Ultrasonography
Doppler
Transcolonic scintigraphy
Radiographic agent placed in the rectum
If activity is detected in heart = Shunt
If activity is detected in liver = no shunt
Contrast Imaging of the PSS
Selective angiography = mesenteric portography
Jejunal vein catheterized at laparotomy
Normal arborizing pattern visible
Where is the spleen attached?
left-dorsal by gastrosplenic ligament
What are the differential diagnoses for Splenomegaly?
General Anesthesia Immune-mediated disease Infiltrative diseases Splenic thrombosis Venous congestion Splenic torsion Hyperplasia due to anemia or infection
What are the Radiographic features of Splenomegaly?
most reliable indicator is rounded or blunt margins
caudal or dorsal displacement of the small intestine
Caudal displacement of left kidney on VD
In what species is the spleen the most likely source of a mass?
Dogs
On what view is cats spleen enlargement seen on?
Ventrally on the lateral radiograph
What do gas bubbles indicate?
Anaerobic bacteria
How does the spleen appear with splenic torsion?
C shape on lateral radiograph
Fundus is displaced caudally and medially
Spleen has enlarged lacy pattern
No blood flow on doppler
What is the diagnostic tool for splenic torsion?
Ultrasound
