Ch. 47- Small Intestines

Question 1

What could the structures that the arrows are pointing represent?

Answer 1

luminal content (animal was not fasted) or physiologic lacteal dilation.

Question 2

Linear or not linear FB

Answer 2

Linear

Question 3

Other than a FB what other things could cause an intestinal obstruction?

Answer 3

Proliferating tissue masses originating within the intestinal
wall include tumors, polyps, and granulomatous infiltrates.

Question 4

Normal or abnormal finding? (different focal decrease in intestinal luminal diameter post contrast adm.)

Answer 4

Normal finding due to peristalsis

Question 5

Causes of intussuceptions include:

Answer 5

motility disorders, inflammatory wall lesions,
neoplasia, foreign bodies, or idiopathic causes.

Question 6

Top Ddx?

Answer 6

Mechanical obstruction

Question 7

Obstruction or not?

Answer 7

No.

Question 8

What do you think about the serosal detail in this projection and why?

Answer 8

Serosal margination is adequate even though it appears to be decreased because intestinal segments may be crowded together by an
abdominal mass or when little or no gas is present in the bowel
lumen

Question 9

The dimensions for the duodenal papilla in dogs are:

Answer 9

mean dimensions of: length 15.2 +/-
3.5-mm, width 6.3+/-1.6-mm, and height 4.3+/-1.0-mm

Question 10

What’s your ddx?

Answer 10

mechanical obstruction

This is an example of a cat that suffered from chronic ileal obtruction due to intestinal adenocarcinoma.

Question 11

True or false. If a dog is anemic you should consider taking abd rads to rule out FB of zinc origin.

Answer 11

True

Question 12

Name the artifact

Answer 12

Ring-down reverberation artifact caused by the gas within the intestinal segment.

Acoustic shadowing artifact occurs
frequently, either with focal luminal gas or with dense particles
of ingesta.

Question 13

What are some things that may increase the radiopacity within the gi loops?

Answer 13

Clay-based cat litter, small gravel from
dog runs, gastrointestinal medications
that contain calcium, magnesium, aluminum, bismuth, or silicate, and
some pet vitamin and mineral supplements

Question 14

Radiographic contrast studies of the small bowel can be used to identify the location of the bowel, patency of the lumen,perforation, and irregularities in the contrast medium/mucosal interface. When would a positive contrast study would not be indicated?

Answer 14

when there is
conclusive survey radiographic evidence of bowel obstruction and evidence of free peritoneal gas that is not residual from recent laparotomy, penetrating trauma, or abdominocentesis

Question 15

In an intussusception, the invaginated portion of the gastrointestinal tract is known as ____. The portion that the invaginated portion invaginates into its lumen is knowns as _____.

Answer 15

intussusceptum

intussuscipiens

Question 16

What are the canine normal small bowel wall thickness
ultrasound measurements

Answer 16

Question 17

Dx of this BIPS study?

Answer 17

There is retention and clustering of the BIPS
in the duodenum. This is highly indicative of an obstruction.

BIPS are used mainly for evaluation of gastric dysmotility
and intestinal transit time in the dog and cat.

Extra info: The spheres are
formulated in two diameters: 1.5 mm and 5 mm. The larger spheres are designed to become trapped at the oral aspect of an obstructing lesion, making them suitable for evaluation of partial and complete obstruction

partial and complete obstruction

Question 18

How many peristaltic waves per min are usually seen in the small intestine?

Answer 18

1-3/min

Question 19

What is the most frequent cause for a
nondiagnostic barium study?

Answer 19

Failure to administer an adequate volume
of contrast medium.

Question 20

In the adult
dog, the normal length of the jejunal lymph nodes ranges from: ________. What about in puppies?

Answer 20

adults: 5 to 200 mm
puppies: 1.5-12.5 mm ( are very prominent and hypoechoic)

Question 21

the ileocolic
junction in the cat has the appearance of:

Answer 21

a wagon wheel

flower (dr moon)

cat butt ( dr cole)

Question 22

What is the recommended dose for a braium sulfate study for dogs and cats?

Answer 22

Question 23

The roentgen signs
assessment for the small intestine are:

Answer 23

Margination: serosal surface definition
Size: diameter of lumen and/or serosa-to-serosa
Position: location within abdominal cavity
Shape: contour of bowel loops
Radiopacity: lumen contents and bowel wall
Architecture: mucosa/bowel wall smoothness
Motility: intermittent narrowing of contractions

Question 24

What are the layers of the intestinal wall and their echogenicity?

Answer 24

lumen- hyperechoic

mucosa- hypoechoic

submucosa- hyperechoic

muscularis- hypoechoic

serosa- hyperechoic

Question 25

Where is the duodenal papilla typically located?

Answer 25

The major duodenal papilla is immediately adjacent to the right limb of the pancreas.

Question 26

Is this FB within the colon? If you are unsure what can u do to confirm where it is?

Answer 26

No most likely it's not in the colon if unsure do a pneumocolonogram

Question 27

Why there is a routine acquisition of three views when evaluating the gastrointestinal tract?

Answer 27

To take advantage of the redistribution of intraluminal gas.

Question 28

What are the canine and feline small bowel normal radiographic measurements?

Answer 28

Question 29

What is your top ddx for this radiographic finding?

Answer 29

Pseudoulcers. this is a normal finding caused by mucosal depressions on the antimesenteric wall over submucosal lymphoid accumulations

Question 30

What is the most thickest intestinal segment in the dog? and in the cat?

Answer 30

dog- duodenum cat- ileum

Question 31

Top ddx?

Answer 31

Ileocolic intussuception Less likely gastric FB

Question 32

The appearance of mechanically obstructed bowel differs from functionally obstructed bowel by the following parameters:

Answer 32

1) mechanically obstructed bowel is usually of larger diameter than functionally obstructed bowel 2) both gas and fluid are typically in the lumen of mechanically obstructed bowel, whereas functionally obstructed bowel tends to contain more gas or may be completely gas filled 3) patients with mechanical obstruction usually have some bowel segments of normal size,whereas patients with functional obstruction may have generalized involvement of the bowel. disclaimer: it will rarely be this easy, these usually overlap.

Question 33

Dog's vomiting. What's your main radiographic interpretation and what would you do next?

Answer 33

Dilation of stomach with fluid and gas. Take a left lateral rad and if you don't see anything either abd ultrasound or keep the dog in lateral recumbency for a couple of min and retake left lateral. Acute duodenal obstruction is harder to dx than chronic (we read this in the previous ch)

Question 34

MC place for intussusceptions to happen?

Answer 34

ileocolic junction or cecocolic but can occur anywhere

Question 35

What's ur dx?

Answer 35

Pneumoperitoneum most likely due to GI perforation. Eventhough a FB is not seen there are some radiopaque materials (such as rare earth magnet, aluminum etc) that may cause a mechanical obstruction and the actual FB will never be seen on rads.

Question 36

Size of feline duodenal papilla

Answer 36

ranges from 2.9 to 5.5 mm wide and averages 4.0 mm in height when imaged in the transverse plane

Question 37

Why ionic iodinated contrast media are not recommended for oral administration in young and debilitated and dehydrated patients?

Answer 37

because the resultant fluid shift can worsen any hypovolemic state.

Question 38

For a BIPS study, the spheres are given with a meal. True or False: The type of meal influences gastric emptying.

Answer 38

True

Question 39

Linear or not linear FB

Answer 39

Linear. Look at the distal small intestinal seg ventral to the L spine they are stacked

Question 40

In cats, the normal lymph node size guidelines are:

Answer 40

pancreaticoduodenal length (L) 8.4 mm (6.6 to 13), diameter (D) 4.6 mm (3.6 to 6.2); jejunal L 20.1 mm (11.4 to 39.0), D 5.0 mm (2.8 to 7.2); and ileocecal L 11.8 mm (6.7 to 23.2), D 4.1 mm (2.7 to 4.8)

Question 41

What are the feline small bowel normal ultrasound measurements?

Answer 41

Question 43

For a contrast study with barium what is the time sequence for taking the radiographs?

Answer 43

Immediate 15 minutes 30 minutes 1 hour 2 hours 4 hours can keep taking rads until barium is gone (not ideal obviously cause u will be there forever)