Transcript Radiology Packet 1

Radiology Packet 40
Miscellaneous Abdomen
8-year old Cocker Spaniel
• Hx: Presented for anorexia and depression of several days duration.
The dog’s abdomen was tender to palpation and appeared bloated.
8-year old Cocker Spaniel
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RF
– In both vies the cranial abdomen is under-exposed and there is a loss of
abdominal detail.
– The gastric axis is caudally displaced indicating hepatomegaly.
– A 10cm soft-tissue opacity mass is present in the left, ventral abdomen.
– The small intestines are displaced caudo-dorsally and to the right by the
enlarged liver and splenic mass.
– There is a loss of abdominal detail in the cranial to mid-abdomen.
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RD
– Hepatomegaly
– Splenic mass
– Free abdominal fluid
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Next
– Ultrasound
3 year old FS DSH
“Shivers”
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RF
– The kidneys are at the lower limits of normal size with the left kidney being
slightly smaller than the right.
– A faint focal area of mineral opacity is present superimposed with the renal pelvic
area in the lateral view.
– The urinary bladder is distended.
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RD
– Kidneys at the lower limits of normal.
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R/O
– Chronic renal disease
– Normal in this patient
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Next
– Evaluate BUN and creatinine levels.
14-year old MC Cocker Spaniel
“Prince”
• Hx: Presented with PU/Pd, an enlarging abdomen, and some anorexia
and diarrhea during the past week.
14-year old MC Cocker Spaniel
“Prince”
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RF
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RD
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Hepatomegaly
Irregular soft tissue mass
Renal mineralization and cystic calculi
R/O
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Liver margin is quite rounded and extends beyond the costal arch.
Irregular soft tissue mass in the right ventral abdomen, caudal to the liver.
Faint mineralization is present overlying both kidneys.
One pea-sized cystic calculus and many tiny calculi are in the urinary bladder.
The abdomen has an mild “pot-belly” appearance but overall serosal detail is good.
The cardiac silhouette is large.
There is an incidental finding of spondylosis of the lumbosacral junction.
Hyperadrenocorticism
Next
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Ultrasound
10-year old M Yorkshire Terrier
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Hx: Presented for straining to urinate.
10-year old M Yorkshire Terrier
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RF
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RD
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Urethral obstruction leading to inability to urinate
Multiple larger cystic calculi
Hepatomegaly
“Pendulous” appearance of the abdomen
R/O
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Markedly enlarged urinary bladder.
Multiple urinary bladder calculi present.
Prostate gland is visible, not too large given the elderly and intact status of patient.
Focal solitary urethral stone noted just proximal to the os penis.
Large, rounded liver.
Hyperadrenocorticism
Next
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Ultrasound
ACTH stimulation test
6-year old cat
“Twisted”
• Hx: Presented for dyspnea. She is anemic.
6-year old cat
“Twisted”
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RF
– The thorax contains a moderate volume of pleural effusion which partially
obscures the cardiac silhouette.
– In the VD view there is an area of opacity noted in the right thorax, which
appears to be continuous with the heart.
– There is caudal displacement of the gastric axis indicating large size of the liver.
– The kidneys are hard to visualize but appear slightly enlarged.
– Serosal detail is diminished.
– There are mineral opacity structure seen in the ventral caudal abdomen which
are believed to be mineral material present within the GI structure.
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RD
– Pleural effusion
– Hepatomegaly
– Ascites
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Next
– Ultrasound
10-year old MC DSH
“Puddy”
• Hx: Presented for depression, anorexia and lethargy of several days
duration. The cranial abdomen is painful to palpation.
10-year old MC DSH
“Puddy”
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RF
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The liver is mildly enlarged.
The spleen is enlarged.
The small intestines are fluid filled but are within normal limits.
In the lateral view there is areas of soft tissue opacity in the mid-abdomen
immediately ventral to the kidneys.
– There is slightly decreased serosal detail.
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RD
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Hepatomegaly
Spleenomegaly
Possible mid-abdominal mass
Possible free abdominal fluid
Next
– Ultrasound
13-year old MN DLH
“Casanova”
• Hx: Listless. Weight loss.
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13-year old MN DLH
“Casanova”
RF
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RD
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Mild hepatomegaly
Bilateral renal enlargement with alteration of renal shape
R/O
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The liver is mildly enlarged.
The left kidney is enlarged and misshapen.
The right kidney is large and misshapen.
The urinary bladder is moderately distended.
Increase in renal size has caused ventral displacement of the intestinal segments.
Neoplasia
Hydronephrosis
Perinephric pseudocyst
Inflammatory disease
Toxicity
Infiltrative disease
Polycystic renal disease
Next
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Ultrasound
11-year old M Poodle
• Hx: Presented with a 3 month history of PU/PD and polyphagia.
Hematuria and dysuria have been noticed for the last 3 weeks. PE
findings include an enlarged, tense abdomen and a thin haircoat.
11-year old M Poodle
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RF
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RD
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Hepatomegaly
Cystic calculi
Urethral calculi
Prostatomegaly (mild)
Possible renomegaly
R/O
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The liver is enlarged and has rounded margins and has caused caudal displacement of the gastric axis.
The kidneys are difficult to visualize on the VD projection but the left kidney appears enlarged.
There are multiple, irregularly shaped mineral opacity structures seen within the bladder.
A mineral opacity structure is seen within the soft tissue in the perineal region.
The prostate is visible caudal to the prostate and is mildly enlarged.
There is gas in the pyloro-duodenal angle and the descending duodenum.
The abdomen appears large relative to the thorax. This may be due to fat deposition (Pickwickian
syndrome).
There is a mild decrease in abdominal detail.
Endocrine disease (Cushing’s disease)
Prostatic disease
Next
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Ultrasound
3-year old M Springer Spaniel
“Higgins”
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Hx: The patient has been vomiting intermittently for 3 weeks. At
presentation the patient is dehydrated and has elevated BUN and WBC
count. He is depressed and tachypneic.
3-year old M Springer Spaniel
“Higgins”
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RF
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RD
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Hepatomegaly
Splenomegaly
Renomegaly (bilateral)
Possible gastric wall thickening
R/O
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The liver is enlarged and has rounded margins and has caused caudal displacement of the
gastric axis.
The spleen is enlarged with rounded margins.
The kidneys are of normal length but are wider than normal.
There is impression of thickening of the gastric wall and the rugal folds are prominent.
The intestinal segments are displaced caudally by the enlarged organs.
The cranial aspect of the urinary bladder is visible in the lateral view.
The abdominal detail is normal.
Infiltrative disease (lymphosarcoma, disseminated mast cell disease.
Gastric wall thickening as a result of edema secondary to vomiting.
Next
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Ultrasound and fine-needle aspiration.
10-year old MN Old English Sheepdog
“Rueben”
• Hx: Abdominal distension. Heart murmur.
10-year old MN Old English Sheepdog
“Rueben”
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RF
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RD
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The cardiac silhouette and pulmonary vessels are at the lower limits of normal size.
There is a mild diffuse interstitial lung pattern that is consistent with the age of the patient.
There is marked loss of abdominal detail.
The stomach is displaced caudo-dorsally and to the left indicating that generalized hepatic
enlargement is present.
The spleen is visible along the left lateral body wall and its’ axial border is nodular.
The small intestinal segments are displaced into the caudal abdomen.
The descending colon is irregularly marginated and gas-filled suggesting serosal
inflammation.
There is an incidental finding of multiple sites of spondylosis throughout the thoracic and
lumbar spine.
Free abdominal fluid
Hepatic enlargement
Possible splenic nodules
Next
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Ultrasound
4-month old M Labrador Retriever
“Midnight”
• Hx: Hit by car. Films taken to rule out thoracic and abdominal
trauma.
4-month old M Labrador Retriever
“Midnight”
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RF
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RD
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Small size of heart and pulmonary vessels
Pulmonary contusions
Gastric distension
Free abdominal fluid
Fracture of the ilium, acetabulum, pelvic floor and mid-dyphyseal femoral fracture
R/O
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The cardiac silhouette and pulmonary vessels are small.
Evaluation of the VD view shows alveolar infiltrates in the right cranial and right middle lung lobes.
Air-bronchograms are visible in the accessory lobe in the lateral view.
The thymus is visible in the left cranial hemithorax.
Abdominal detail is poor in this patient.
The caudoventral margin of the stomach extends caudally due to a large amount of fluid and some gas
causing the gastric distension.
Small intestinal segments are displaced caudally by the gastric distension.
Fracture of the ilium is visible and it is seen extending into the acetabulum.
Pelvic floor fractures and a mid-diaphyseal fracture of a femur is also seen.
Hypovolemia causing decrease heart and pulmonary vessel size
Ileus resulting in gastric distension
Next
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Abdominocentesis
2-year old FS Siamese cat
“Tao”
• Hx: Presented for lethargy and weight loss.
2-year old FS Siamese cat
“Tao”
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RF
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RD
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Bilateral renal enlargement.
Decreased abdominal detail.
Mild liver enlargement.
Granular material in small intestine
Renomegaly
Ascitis
Probably partial SI obstruction
Mild hepatomegaly
Next
– Ultrasound
– Abdominocentesis
– Renal fine needle aspirate or biopsy