Liver, Gallbladder, Spleen Flashcards
What is this?
Falciform Fat
How do you decide whether to evaluate an abdomen with an US or rads?
US: patients with lots of peritoneal fluid or without large fat stores (very young or cachexic animals)
Rads: patients with lots of gas or food in GIT or peritoneal gas
Hepatomegaly detected or not detected?
Detected - gastric axis is shifted caudally, especially on the right side indicating hepatomegaly more severe in the right lobes of the liver
T or F - Ultrasound is ideal for doing size assessments.
False - US is not ideal for doing size assessments because it is much harder to see size of one structure relative to other structures as you would on rads.
Hepatomegaly detected or not detected?
If yes - what disease is likely?
Detected - you can see the caudal border going past the rib cage. Endocrine disorder is suspected due to the liver still being triangular in shape (margins not rounded).
This dog is hyperthyroid.
What are the possible causes of and enlarged liver with rounded margins? What is the next step in confirming a diagnosis?
- congestion
- infiltrative disease - i.e. lymphoma
- acute hepatitis
To confirm a diagnosis or come up with a narrowed Ddx list use ultrasound and do a biopsy.
You are looking at abdominal x-rays on a dog and notice that the gastric axis is shifted cranial. What liver problem is likely and what diseases are on your DDX list?
Microhepatica caused by:
- liver shunting (more likely in young)
- chronic hepatitis (liver likely nodular/irregular)
- cirrhosis (liver likely nodular/irregular)
Diaphragmatic hernia or having a deep chested dog can also falsely cause the liver to appear small.
You are seeing a young yellow lab that seems to have microhepatica on his rads - what SPECIFIC disease are you thinking of?
Congenital, intrahepatic, left sided shunt due to patent ductus venosus -
- Congenital more common in youngsters
- Intrahepatic more common in large breed dog
- Intrahepatic common on the left side due to PDV
What is going on in this ultrasound?
This is a protsystemic shunt - you can see the portal vein and the caudal vena cava and the fact that they are very obviously connected by something of fluid opacity through the liver.
On doppler you would see turbulent flow throughout which you should never see turbulent flow in either portal vein or CVC, should only be seeing unidirectional flow in a healthy animal.
You are performing transcolonic scintography on a patient and activity is detected in the liver before the heart. Is portosystemic shunt detected or not detected?
Not detected - if there is a PSS activity will be seen in the heart first.
Choleliths - detected or not detected?
Detected
Cholecystitis - detected or not detected?
Detected! If the wall is thick enough to specifically be seen on US it is highly suspect. This was 6 mm thick!
What are the best indicators of splenomegaly?
Rounded or blunted margins.
In cats, if you can see the spleen ventrally on a lateral radiograph it is enlarged.
This is the spleen. What is your diagnosis? Was ultrasound the best choice to diagnose this?
Splenic torsion - spleen is HUGE (usually more like 2 cm across - this is 7 cm) and has lacy pattern with heterechoic quality.
If the ultrasound had a box on it for color doppler we would see NO color because there is no blood flow. The vessels would show gray.
Ultrasound IS the best diagnostic for splenic torsion because it lets you look at the parenchyma.
Which specific liver lobes can be seen on ultrasound?
The lobe that points caudoventrally on lateral projection:
- dog - left lateral lobe
- cat - right lateral lobe
