Liver, Gallbladder, and Spleen

Question 1

When do you use ultrasound for the Liver, Gallbladder or Spleen?

Answer 1

large accumulations of peritoneal fluid or those patients without larger fat stores (Cachexia or young patients)

Question 2

When do you use radiographs for the Liver, Gallbladder or Spleen?

Answer 2

In patients with a lot of gastrointestinal tract gas, food in the gastrointestinal tract or peritoneal gas

Question 3

What is the enemy of ultrasound?

Answer 3

AIR

Question 4

If disease is suspected and no radiographic or ultrasonographic changes found, what then?

Answer 4

Biopsy

Question 5

How many lobes do dogs and cats have for their liver?

Answer 5

6 lobes and 2 processes

Question 6

What lobes of the liver are visible on radiographs?

Answer 6

the lobe that points caudoventrally on the lateral projection
Left lateral in the dog
Right Lateral lobe in the cat

Question 7

What should the gastric axis be parallel with?

Answer 7

The Ribs

Question 8

What should the gastric axis be perpendicular with?

Answer 8

the Spine

Question 9

What are the Differential Diagnoses for a cranial displacement of the gastric axis?

Answer 9

Diaphragmatic hernia
Ascites
Pregnancy
The Liver is small

Question 10

What are the DIfferential Diagnoses for a caudal displacement of the gastric axis?

Answer 10

Hepatomegaly
Inguinal Hernia
Pleural effusion
tension pneumothorax

Question 11

If the liver is enlarged….

Answer 11

May displace gastric axis caudally
May extend past costal arch
Pylorus may move medially on VD
Increased soft tissue opacity cranially

Question 12

If the Liver is small…

Answer 12

Gastric axis is cranially displaced

Reduced soft tissue opacity cranial abdomen

Question 13

What causes the Liver to appear enlarged due to the lungs?

Answer 13

Lungs are over-inflated due to dyspnea and pleural effusion

Question 14

If the margins of the liver are triangular or slightly rounded then consider what?

Answer 14

Endocrine disorders:
Diabetes mellitus resulting in hepatic lipidosis
Hyperadrenocorticism

Question 15

Microhepatia

Answer 15

Reduction in liver size

Question 16

What are the differential diagnoses for Microhepatia?

Answer 16

Liver shunting
Chronic hepatitis
Cirrhosis
Diaphragmatic hermia

Question 17

Portal Systemic Shunt

Answer 17

Shunt from portal vein to CVC or azygous vein

bypasses the liver

Question 18

What side is Intrahepatic PSS more common on?

Answer 18

Left side

Question 19

What modality do you use to see PSS?

Answer 19

Ultrasonography

Doppler

Question 20

Transcolonic scintigraphy

Answer 20

Radiographic agent placed in the rectum
If activity is detected in heart = Shunt
If activity is detected in liver = no shunt

Question 21

Contrast Imaging of the PSS

Answer 21

Selective angiography = mesenteric portography
Jejunal vein catheterized at laparotomy
Normal arborizing pattern visible

Question 22

Where is the spleen attached?

Answer 22

left-dorsal by gastrosplenic ligament

Question 23

What are the differential diagnoses for Splenomegaly?

Answer 23

General Anesthesia 
Immune-mediated disease
Infiltrative diseases 
Splenic thrombosis 
Venous congestion 
Splenic torsion 
Hyperplasia due to anemia or infection

Question 24

What are the Radiographic features of Splenomegaly?

Answer 24

most reliable indicator is rounded or blunt margins
caudal or dorsal displacement of the small intestine
Caudal displacement of left kidney on VD

Question 25

In what species is the spleen the most likely source of a mass?

Answer 25

Dogs

Question 26

On what view is cats spleen enlargement seen on?

Answer 26

Ventrally on the lateral radiograph

Question 27

What do gas bubbles indicate?

Answer 27

Anaerobic bacteria

Question 28

How does the spleen appear with splenic torsion?

Answer 28

C shape on lateral radiograph
Fundus is displaced caudally and medially
Spleen has enlarged lacy pattern
No blood flow on doppler

Question 29

What is the diagnostic tool for splenic torsion?

Answer 29

Ultrasound