Stomach

Question 1

What is the normal positioning of the stomach

Answer 1

Lateral:
-empty stomach usually cranial to last pair of ribs
-gastric axis parallel to the ribs, perpendicular to spine or somewhere between
-pylorus may be superimposed over body
-ratio of diameter of fundus to pylorus (on lateral) = 3:2

Ventrodorsal:
-Long axis of stomach is perpendicular to the spine
-May have V-shape
-Pyloric sphincter usually lcoated in the right cranial abdomen at approx 10th or 11th ribs

Question 2

The size and shape of the stomach depends on

Answer 2

1) Species, breeds
2) Degree of Distention
3) Volume
4) Type of gastric contents
5) Positions of patient

Question 3

the empty stomach is usually ______ to the last pair of the ribs on lateral

Answer 3

Cranial

Question 4

What lateral view can you view fluid in the fundus

Answer 4

Left Lateral

Question 5

What lateral view can you view gas in the fundus

Answer 5

Right Lateral

Question 6

What lateral view can you view gas in the pylorus

Answer 6

Left Lateral

Question 7

What lateral view can you view fluid in the pylorus

Answer 7

Right Lateral

Question 8

If you are given only one lateral to image the stomach you should do a

Answer 8

Left lateral
examine if there is gas in the pylorus
really helpful for vomiting patient

Question 9

What causes an enlarged stomach

Answer 9

1) Gastric dilation (dietary indiscretion)
2) Gastric dilation and volvulus (GDV)
3) Pyloric outflow obstruction
-Pyloric stenosis
-Neoplasia
-Foreign body

Question 10

What appearance does kibble have on radiographs

Answer 10

heterogenous

Question 11

What are the radiographic signs of GDV

Answer 11

1) Large Gastric Size
2) Stomach position abnormal
pylorus becomes left dorsal
fundus becomes right ventral
3) Primarily gas opacity in the lumen
4) Compartmentilization- Double Bubble

Question 12

What view should you start with if you suspect GDV

Answer 12

Right lateral
examine the double bubble appearance

Question 13

What view can you see the double bubble appearance of the stomach

Answer 13

Right lateral recumbency

Question 14

narrowing or occlusion of the pyloric orifice
caused by chornic diseases affecting wall or blocking the opening

Answer 14

pyloric outflow obstruction

Question 15

What might cause pyloric outflow obstriction

Answer 15

1) Chronic Diseases
-Hypertrophic pyloric stenosis
-Pyloric tumors/granulomas
-Pyloric inflammation or fibrosis

2) Acute outflow obstruction -> foreign body

Question 16

What are the rad finidngs of pyloric outflow obstruction

Answer 16

1) Fluid filled gastric distention (soft tissue opacity)
more severe with chronic, acute has moderate

2) Small gas bubblile within the fluid filled lumen

+/- displacement of SI caudally or particulate matter in the lumen (gravel sign)

Question 17

hypertrophy of circular muscle fibers of pylorus
congenital and acquired forms
cause unknown
present in brachycephalic breds and siamese cats

Answer 17

Pyloric Stenosis

Question 18

What are the clinical findings of pyloric stenosis

Answer 18

1) Enlarged stomach with fluid in the pylorus
2) String sign- thin strand of contrast through severely thickened pylorus into the proximal duodenum after barium administration
3) May also see gravel sign

Question 19

Gastric neoplasia is dogs is commonly

Answer 19

Adenocarcinoma (often pylorus)

Question 20

Gastric neoplasia in cats is commonly

Answer 20

lymphoma

Question 21

What should you do for nondescript radiopaque material in the stomach lumen

Answer 21

Persistence on Repeat Rads?
Air Surrounding the material?
Clinical signs? vomiting, etc