Ex 1 - Stomach Flashcards Preview

726 Imaging Interpretation > Ex 1 - Stomach > Flashcards

Flashcards in Ex 1 - Stomach Deck (15):
1

Cat vs Dog - Stomach position

Dog: cardia, fundus, and body located to the left of midline and pyloric portion on the right

Cat: stomach is more acutely angle with the pylorus located at or near midline (stomach on left)

2

Positive Contrast Gastropgraphy - Indications

1. Acute & chronic vomiting: surgery rads don't show definitive obstructive pattern
2. Recurrent vomiting: esp in patients not responding to supportive therapy or other systemic dz to cause vomiting
3. Suspect GI FB, mass, or outflow disorder

4. Hematemesis (vomiting blood): suspect GI ulcer
5. Evaluate liver size
6. GI emptying times
7. Positive & size of stomach (ex. GDV - if not well visualized on rads)

3

Negative contrast gastrogram

Intubate into the stomach --> pump with air

4

Causes of an enlarged stomach

1. Gastric dilation --> dietary indiscretion "food bloat"
2. GDV
3. Pyloric outflow obstruction
- pyloric stenosis
- neoplasia
- FB
4. Gastric motility disorder

5

GDV - stomach position

Pylorus (& duodenum) --> left dorsal quadrant

Fundus --> right ventral quadrant

6

GDV - Rad findings

- large gas filled stomach
- double bubble sign
- gas w/in the gastric wall = necrosis
- displacement and enlargement of spleen
- functional ileum, esophageal dilation, microcardia, pulmonary hypovolemia

7

Double bubble sign (GDV)

Compartmentalization

Soft tissue bands that project into or across the gas-filled lumen of the rotated stomach

Result from the stomach folding upon itself

8

GDV; RLR

Pop-eye arm or angry bunny sign

- gas in the pylorus should outline it and enable ID of pyloric positioning

*start with RLR view

9

Pyloric Outflow Obstruction - underlying cause

Narrowing or occlusion of the pyloric orifice

Acute vs Chronic

10

Pyloric Outflow Obstruction - Dz's affecting the wall or blocking the opening

- Hypertrophic pyloric stenosis
- Pylorospasm
- Pyloric tumors or granulomas
- Pyloric inflammation or fibrosis
- FB, GDV (acute outflow obstruction)

11

Pyloric Outflow Obstruction - Rad Findings

** Fluid-filled gastric distention (soft tissue opacity - compared to gas as in GDV)

** Particulate matter in lumen ("Gravel Sign")

+/- gas bubble

intestines pushed caudally

12

Pyloric stenosis

Hypertrophy of the circular mm fibers

On rads (contrast) it looks "cut off" from stomach to duodenum

- congenital and acquired forms
- cause is unknown
- brachycephalic breeds and siamese cats

13

Gastric Neoplasia - Dogs and Cats

Dogs: Adenocarcinoma (most often in pylorus)

Cats: Lymphoma


**Neoplasia may be more readily ID'd with US

14

Apply Core sign

Compression of pylorus creates apple core sign between stomach and duodenum

15

Challenges of Gastric FB

1. Non-descript radiopage material in lumen

2. Radiolucent FB

**hard to see: look at CS, move patient to utilize gas in stomach lumen. repeat rads, +/- contrast, endoscopy if available