Radiology Packet 32

1. Radiology Packet 32 Gastrointestinal II

2. 15 yr old MC DSH“Puddy” • HX = two week history of intermittent lethargy and anorexia, one episode of straining to defecate

3. 15 yr old MC DSH“Puddy”

4. 15 yr old MC DSH“Puddy” • RF • Both kidneys are small and irregularly shaped with the left being smaller than the right. • Multiple foci of mineralization are present in the renal pelvises bilaterally. • The colon contains a large amount of formed and solid appearing granular material and is at the upper limit of normal diameter in some areas. • Spondylosis is present at L6-7 and metallic structures are present in the inguinal ring. • RD • Chronic renal disease • Constipation/obstipation is present

5. 8 yr old MC DSH • HX = presented for weight loss, palpation reveals a possible abdominal mass

6. 8 yr old MC DSH

7. 8 yr old MC DSH • RF • The stomach is visible in both views as a collapsed soft-tissue structure. • In the lateral view the stomach is cranially displaced and the liver is well within the costal arch. • Both kidneys are considered small. • A large, irregular soft-tissue mass is present in the left cranioventral abdomen and in both views there is a tubular gas shadow within the mass. • Mineral material is present within the mass and the mass is displacing the colon to the right. • Small intestinal loops are fluid-filled and some are mildly distended. • There is focal loss of abdominal detail in the right cranial to mid abdomen in the VD and in the cranioventral abdomen in the lateral view. • RD • Abdominal mass • Free abdominal fluid • Next • Ultrasound and biopsy

8. 7 yr old FS Persian“Princess” • HX = the owner notices she is spending a lot of time in her litterbox, she is straining but has not passed stool in 4 days

9. 7 yr old FS Persian“Princess”

10. 7 yr old FS Persian“Princess” • RF • There is a large amount of solid-appearing fecal material in the colon that completely fills the colon. • The colon is approximately 2 times the length of L7 vertebral body. • A faint focal area of increased opacity seen ventral to L6 in the lateral view may be a “Bate’s Floater” which are necrotic fat bodies that undergo mineralization and are an incidental finding. • The kidneys are normal in size and shape. • The spleen is visible along the left lateral body wall and is normal. • RD • Megacolon • Next • Surgical Resection • Enema if not too severe

11. 1 yr old MC DSH“Bootsie” • HX = presented for vomiting, anorexia, depression for one day, last night he vomited a penny

12. 1 yr old MC DSH“Bootsie”

13. 1 yr old MC DSH“Bootsie” • RF • A rectangular shaped mineral structure is present within the mid-abdomen, near midline at the level of L2. • Small intestines are mostly fluid filled, larger than normal diameter, and appear to be bunched centrally. • On the VD view the SI appear corrugated along the right body wall. • The stomach has an abnormal appearance on the lateral view, being a bit displaced caudally and elevated it contains many air bubbles. • RD • Enlarged small intestine, possible linear foreign body • Small intestine mineral foreign body • Possible low-grade ascites • Next • Ultrasound • Surgical exploratory

14. 5 yr old FS DSH“Biddy” • HX = 2 day history of anorexia and vomiting, she is depressed and dehydrated on physical exam

15. 5 yr old FS DSH“Biddy”

16. 5 yr old FS DSH“Biddy” • RF • Gas distended stomach. • Gas and fluid dilated SI, larger diameter than normal. • There is a back and forth bowel pattern, plication. • This plicated region is the duodenum on both views. • There is a transitional lumbosacral segment and spondylosis of this region. • Mild DJD of the hips. • RD • Linear foreign body within the proximal small intestine • Possible gastric foreign body • Next • Surgery

17. 5 mo old MC Mixed breed dog“Buster” • HX = presented for history of vomiting and diarrhea for 4 days

18. 5 mo old MC Mixed breed dog“Buster”

19. 5 mo old MC Mixed breed dog“Buster” • RF • Nearly all of the small intestinal loops are fluid and gas distended beyond normal limits. • The colon is difficult to follow, regardless there are too many loops of distended bowel to be accounted for solely by the colon. • The stomach appears to be pushed cranially by the dilated SI. • The liver is mildly enlarged, extending beyond the costal arch. • RD • Generalized distended SI • Next • CBC • Parvo stool test • Abdominal ultrasound

20. 3 yr old M Dalmatian“Jake” • HX = history of several days of vomiting

21. 3 yr old M Dalmatian“Jake”

22. 3 yr old M Dalmatian“Jake” • RF • Gas distended loops of small intestine. • Plicated appearance of some of these SI loops. • Some SI loops contain “fecal-like” material, seen on both the VD and lateral views. • RD • Partial SI obstruction • Next • Surgery

23. 5 mo old F DSH“Marshmello” • HX = presented because she ate a large screw ½ hour prior to presentation

24. 5 mo old F DSH“Marshmello”

25. 5 mo old F DSH“Marshmello”

26. 5 mo old F DSH“Marshmello”

27. 5 mo old F DSH“Marshmello” • RF • Large metallic foreign body in an otherwise ingesta filled stomach • Previously noted gastric foreign body is now in the small intestine, no evidence of dilation is seen. • Previously noted foreign body is now in the descending colon at the pelvic inlet. • RD • Gastric foreign body that passed normally through GI tract • Next • Monitor feces for passage, if not seen repeat radiographs