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Year 1/2 > Digestion & Metabolism 2: Radiology of GI ABNORMAL > Flashcards

Digestion & Metabolism 2: Radiology of GI ABNORMAL Flashcards

1
Q

in SURVEY RADIOGRAPHS for GI FOREIGN BODIES, they can ONLY BE SEEN IF THEY’RE….

2 examples of the consistency of the material?

IF there’s ___ in the stomach, we might be able to see these foreign bodies better!

A

ONLY SEEN IF THEY’RE SUFFICIENTLY RADIO-OPAQUE

2 examples?
1. MINERAL
2. METALLIC

GAS in the stomach can help visualize by GAS POCKET OUTLINING FOREIGN BODY

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2
Q

describe image

A

due to GAS present in the PROXIMAL DUODENUM, able to see OUTLINE OF FOREIGN BODY

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3
Q

CONTRAST studies for GI FOREIGN BODIES…
= how does it work?

A

= PUT IN POSITIVE CONTRAST and look for INTRALUMINAL FILLING DEFECT due to presence of FOREIGN BODY

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4
Q

what kind of imaging is this?

where is the foreign body?

A

CONTRAST study for FOREIGN BODY

FOREIGN BODY in PYLORIC REGION

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5
Q

US for FOREIGN BODIES…
commonality? (2)
what 2 things do we usually see?

A

commonality?
1. DONE MOST COMMONLY bc EASIEST & CAN VISUALIZE MOST FBs (most will resorb & reflect US beam)
2. usually done after SURVEY RADS if we’re still concerned about FB

2 things?
1. PROXIMAL face of the FOREIGN BODY
2. STRONG CLEAN ACOUSTIC SHADOW beneath it occluding the rest of the image

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6
Q

what is this US showing??

A

STRONG CLEAN ACOUSTIC SHADOW due to FOREIGN BODY in STOMACH and JEJUNUM

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7
Q

YELLOW ARROW vs. RED CIRCLE in image?

A

YELLOW ARROW = STRONG CLEAN ACOUSTIC SHADOWING from FOREIGN BODY

RED CIRCLE = DISTENDED SI due to PROXIMAL to FOREIGN BODY

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8
Q

LINEAR foreign body…
common in WHAT species?
usually appears as a ____-____ structure that is ____ somewhere, such as… (2)
4 common findings on SURVEY radiographs?

A

common in CATS

usually a STRING-LIKE STRUCTURE that is ANCHORED…
1. AROUND THE TONGUE
2. or PYLORIC SPHINCTER

4 common findings?
1. LOOPS OF INTESTINE BUNCHED UP/PLICATING
2. IRREGULAR GAS LUCENCIES
3. CORRUGATED, IRREGULAR CONTOUR OF INTESTINAL LOOPS
4. possible FOCAL LOSS OF CONTRAST because of INTESTINE PLICATED OVER ITSELF or INFLAMMATION

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9
Q

describe this image (3)

A
  1. LINEAR FOREIGN BODY OBSTRUCTION
  2. because LOOPS OF INTESTINE ARE BUNCHED UP/SHRINKING AGAINST FOREIGN BODY in a SMALL AREA OF ABDOMEN
  3. SCALLOPED MARGIN of SEROSA of intestine
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10
Q

describe something about the INTESTINES in here?

hint: it’s a LINEAR FOREIGN BODY

A

ABNORMAL GAS PATTERN because as INTESTINE PLICATES UP AGAINST LINEAR FOREIGN BODY, GAS gets trapped between INTESTINAL WALL

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11
Q

findings for LINEAR FOREIGN BODY on UPPER GI BARIUM SERIES?

A

look for PLICATED CONTRAST in LUMEN

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12
Q

difference between PLICATED CONTRAST in intestinal lumen due to FB vs. PEARL ON STRING pattern for normal peristalsis?

A

ABNORMAL, IRREGULAR MARGINS in FB vs. NORMAL, UNIFORM appearance of “pearls”

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13
Q

describe what’s happening in the US with a LINEAR FB

A

BOTTOM HYPERECHOIC STRIP = FOREIGN BODY

TOP FOLDS = INTESTINE IS PLICATING ON ITSELF due to LINEAR FOREIGN BODY

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14
Q

GASTRIC DILATATION VOLVULUS…

how is it diagnosed?
CLASSIC GDV definition?
what would we see on a LEFT lateral view if there’s a GDV? what about RIGHT?
where do the FUNDUS and PYLORIC ANTRUM generally move?
what is one DANGER we should be looking for on RADS? (2)

A

diagnosed? = DIAGNOSED VIA RADIOGRAPHS

CLASSIC GDV = 180 rotation along LONG AXIS OF ANIMAL

views?
–> LEFT lateral view = GAS IN FUNDUS
–> RIGHT lateral view = GAS IN PYLORIC ANTRUM

FUNDUS & PYLORIC ANTRUM?
–> FUNDUS = moves VENTRALLY & TO THE RIGHT
–> PYLORIC ANTRUM = moves DORSALLY & TO THE LEFT

DANGER on rads?
1. RUPTURE of gastric walls due to RUPTURE OF GASTRIC ARTERIES, leading to NECROSIS
2. gas will LEAK OUT OF STOMACH INTO ABDOMEN –> PNEUMOPERITONEUM

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15
Q

if the FUNDUS is filled with gas in a GDV case, WHAT VIEW IS THIS?

A

LEFT LATERAL

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16
Q

what is filled with GAS here if it’s the RIGHT lateral side and HAS A GDV?

A

PYLORIC ANTRUM

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17
Q

ESOPHAGUS in GDV patients?

A

SEVERE DISTENSION of the ESOPHAGUS CRANIAL TO THE STOMACH because CARDIA IS BLOCKED and AIR CANNOT MOVE PAST IT/INTO STOMACH

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18
Q

what are we seeing here in a GDV animal?

A

RUPTURE from NECROSIS of the GASTRIC WALL due to GDV and causing PNEUMOPERITONEUM

19
Q

4 most common neoplasias we see on the WALLS of GI tract?

3 common sings?

A
  1. carcinoma
  2. lymphoma
  3. leiomyoma/sarcomas
  4. GI stromal tumors

signs? = TEND TO BE CHRONIC
1. V+
2. D+
3. inappetence

20
Q

it is ____ to diagnose NEOPLASIA on SURVEY RADIOGRAPHS because…

A

UNCOMMON, because they’re usually SMALL and NOT PRESENT RADIOGRAPHICALLY/DO NOT CAUSE OBSTRUCTION

21
Q

PARTIAL-CHRONIC OBSTRUCTION…
= what is it in relation to neoplasia?
what SIGN do we usually see?

A

= when a NEOPLASTIC MASS in the INTESTINE so ONLY SOME THINGS CAN GO THROUGH, usually only UNDIGESTIBLE THINGS can go through (sand or gravel)

MATERIAL can then form a RADIO-OPAQUE, GRANULAR sign = GRAVEL SIGN

22
Q

SURVEY RADIOGRAPH with recent cancer diagnosis…

WHAT IS THIS?

A

GRAVEL SIGN from PARTIAL-CHRONIC OBSTRUCTION

23
Q

UPPER GI BARIUM SERIES when looking for GI NEOPLASIA..
what defect are we looking for?
what’s the “common name” for this sign?

A

look for INTRAMURAL filling defect = something that’s BLOCKING CONTRAST FROM FILLING LUMEN but is CONTINUOUS WITH WALL OF INTESTINE

“APPLE CORE” sign!

24
Q

what pathology is this showing in GI tract?

what is the OFFICIAL & COMMON name for the sign?

A

showing GI MASS (neoplasia)

OFFICIAL = INTRA-MURAL FILLING DEFECT

COMMON = APPLE CORE SIGN

25
Q

describe the LESION & LOCATION on US

A

SMALL INTESTINAL TUMOR

26
Q

ULTRASOUND is the ____ way to ID intestinal or gastric lesion & also allows you to….

A

FASTEST, PERFORM CYTOLOGY ON GI MASSES VIA US-GUIDANCE to DIAGNOSE the tumor

27
Q

3 common findings on US for FOCAL GI NEOPLASTIC MASSES?

A
  1. THICKENING of the WALL
  2. FOCAL MASS with LOSS OF NORMAL LAYERING
  3. usually HYPOECHOIC (dark)
28
Q

SMALL CELL LYMPHOMA…
common in WHAT species?
usually forms WHAT TYPES of lesions? (& what LAYER of SI most affected?)
what OTHER disease could this present as on US? & how do we distinguish?

A

common in CATS

usually forms DIFFUSE THICKENING OF INTESTINAL WALL with MUSCULARIS LAYER MOST AFFECTED/THICKENED

other DZ?
–> INFLAMMATORY BOWEL DZ LOOKS THE SAME ON US

DISTINGUISH VIA BIOPSY W/ HISTOPATHOLOGY

29
Q

ID what is ABNORMAL & DZ (2 possibilities)

A

ABNORMAL = MUSCULARIS MUCOSA IS THICKENED

DZ?
1. SMALL CELL LYMPHOMA
2. INFLAMMATORY BOWEL DZ

30
Q

ULCERATION in GI….
diagnosis? (2)
2 most common locations? & why?
what do we OBSERVE on US?

A

diagnosis?
1. DIFFICULT
2. best diagnostic method = ENDOSCOPY/GASTROSCOPY

2 most common locations? & why?
1. STOMACH
2. PROXIMAL DUODENUM
HAS THE MOST ACID PRESENT IN GI TRACT

what do we see?
1. FOCAL THICKENING OF WALL
2. BLURRING OF LAYERS
3. BRIGHT BUBBLES OF GAS BEING RELEASED

31
Q

INTUSSUSCEPTION…
predisposed on WHAT age dogs/why?
most common location?
a common finding?
how can we ARTIFICIALLY visualize this? what 2 things will we find?

A

predisposed in YOUNG dogs because usually appears after VIRAL or PARASITIC ENTERITIS

most common location?
–> ILEOCOLIC JUNCTION (ileum telescopes into colon)

findings?
1. if GAS is already present, it can, SAUSAGE-LIKE SOFT TISSUE OPACITY

ARTIFICIALLY visualize this?
–> BARIUM ENEMA, look for…
1. INTERRUPTION OF CONTRAST MATERIAL
2. INTRA-MURAL FILLING DEFECT

32
Q

describe the LESION on this CAUDAL RADIOGRAPH

A

ILEOCOLIC INTUSSUSCEPTION

33
Q

what IMAGING method is being used? what’s the lesion?

A

BARIUM ENEMA being used for ILEOCOLIC INTUSSUSCEPTION

34
Q

what LESION is this?
LEFT vs. RIGHT?
why do we see this?

A

ILEOCOLIC INSUSSUSCEPTION

LEFT vs. RIGHT?
–> LEFT = TRANSVERSE “bullseye” sign
–> RIGHT = LONGITUDINAL “layered cake” sign

why do we see this?
–> MULTIPLE histologic layers/intestinal walls STACKED ON TOP OF EACH OTHER

35
Q

why do we use GI imaging? (basic)

A

TO DETERMINE IF WE NEED TO TREAT THE ANIMAL MEDICALLY or TAKE THEM TO OR

36
Q

ACUTE GASTROENTERITIS…
how is this diagnosed? (2)
what can you see on RADS & US?

A

diagnosis?
—> GENERALLY, Dx of EXCLUSION

RADS & US?
–> RADS = SIGNS OF FUNCTIONAL ILEUS (decreased motility and mild dilatation)
–> US = FLUID DISTENSION & DECREASED PERISTALSIS

37
Q

INFLAMMATORY BOWEL DZ…
this is a ____ ____
common in WHAT species?
which imaging is MOST USEFUL? & why?
another DDx? (1) how to distinguish?
what 4 things can be seen?

A

CHRONIC ENTEROPATHY

common in CATS

which imaging is MOST USEFUL? & why?
–> US, can detect THICKENED SEGMENTAL WALL

another Ddx? –> SMALL CELL LYMPHOMA (need biopsy/histopath)

what 4 things can be seen?
1. DIFFUSE THICKENING OF WALL (muscularis mucosa)
2. INCREASED ECHOGENICITY
3. SPECKLING = BRIGHT SPOTS IN MUCOSA
4. MOTTLED with HAZY ECHOES

38
Q

LYMPHANGIECTASIA…
= what is it?
associated with… & can cause…
signs in US? (2)
common in WHAT BREED?

A

= a CHRONIC ENTEROPATHY of the INTESTINE where there’s DILATATION of LACTEALS in INTESTINAL WALL

associated with PROTEIN-LOSING ENTEROPATHY & can cause PERITONEAL EFFUSION

signs in US?
1. causes STRIATED APPEARANCE OF MUCOSA
2. pockets of ANECHOIC EFFUSION around INTESTINAL LOOPS

common in YORKIES

39
Q

ILEUS…
= definition?
2 types?
how is each type treated?

A

= ANYTHING that is IMPAIRING NORMAL TRANSIT OF MATERIAL FROM STOMACH –> COLON

2 types?
1. MECHANICAL ileus = PHYSICAL reason for things not being able to move through
2. FUNCTION ileus = FUNCTIONAL DISORDER that PREVENTS NORMAL CONTRACTIONS OF GI TRACT

treatment?
1. MECHANICAL = SX
2. FUNCTIONAL = MEDICATION

40
Q

MECHANICAL ileus…
= definition
2 variations/definitions?
what 3 reasons can there be for it to be DIFFICULT to diagnose?

A

= OBSTRUCTION of the LUMEN of GI tract by a PHYSICAL OBJECT

2 variations?
1. COMPLETE = completely blocks contents from passing through
2. INCOMPLETE = SOME contents can pass through

can be DIFFICULT to diagnose on RADS if…
1. PARTIAL obstruction
2. RECENT obstruction, NOT ENOUGH TIME FOR INTESTINE TO DILATE
3. OBSTRUCTION IS VERY CLOSE TO STOMACH

41
Q

FUNCTIONAL ileus…
= definition
3 causes?

A

= DECREASED CONTRACTILITY of INTESTINE or STOMACH

3 causes?
1. ELECTROLYTE IMBALANCES (can occur after D+ or V+)

  1. IRRITATION (enteritis or peritonitis) causes PARALYSIS of GI
  2. LOSS OF BLOOD SUPPLY TO SEGMENTS OF INTESTINE WILL STOP WORKING
42
Q

on SURVEY radiographs, in MECHANICAL ileus, expect these 2 findings

A
  1. MARKED DILATATION for everything PROXIMAL/ORAD to obstruction and EMPTY in DISTAL/ABORAD to obstruction
  2. MIGHT see PERISTALTIC CONTRACTIONS
43
Q

if we have QUESTIONABLE SURVEY RADS but we SUSPECT ILEUS…
if STABLE? (4)
if NOT STABLE? (3)

A

if STABLE?
1. HOSPITALIZE PATIENT
2. KEEP PATIENT NPO (DO NOT FEED)
3. PUT PATIENT ON FLUID THERAPY
4. REPEAT RADS 8-10 HOURS AFTER THE FIRST ONE

if NOT STABLE?
1. UPPER GI BARIUM RADIOGRAPHIC SERIES
2. ULTRASOUND
3. EXPLORATORY LAPAROTOMY if necessary

Year 1/2 (139 decks)

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