Abdominal masses

image of Abdominal masses
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The identification of the origin of abdominal masses depends on a knowledge of normal radiographic anatomy, as it is often the indirect mass effect on other organs that gives the clue to the principal organ involved. Whilst the origin of the lesion may be obvious in some cases, often it is a case of elimination of normal structures using, most commonly, radiographic and ultrasonographic examination. The normal extent of anatomical variation should also be considered, especially in those structures that are capable of considerable physiological variation, such as the stomach, bladder and uterus. The chapter looks at the following: Radiographic techniques; Normal variants as ‘pseudomasses’; Principles of localization; Differential diagnoses; Ultrasonography; and Overview of additional imaging modalities.

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8.1 Pre-compression and compression radiographs in a cat, demonstrating a linear foreign body. Due care must be taken with radiation safety when applying compression. (Courtesy of R O’Brien)
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8.2 Intravenous urography used in a dog to differentiate a splenic mass from a retroperitoneal mass, by outlining the position of the kidneys. Contrast medium is seen within the renal pelves ventral to L1 and L2.
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8.3 Differential diagnoses of abdominal masses based on location of the organ of origin. Lateral and VD radiographs showing abdominal sections.
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8.4 Lateral and VD views of a right-sided liver mass in a dog. The intestines have been displaced caudally and to the left side.
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8.5 Lateral view of a pedunculated liver mass in a dog. The gas-filled fundus of the stomach can be seen in a cranially displaced position, whilst the intestines have been displaced caudoventrally.
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8.6 Lateral view of a mass in the body of the spleen in a dog. A well demarcated ‘beak’ can be seen at the caudal extent of the mass.
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8.7 Lateral view of a mass in the tail of the spleen, illustrating a markedly caudoventral position, with subsequent cranial and dorsal displacement of the small intestines.
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8.8 Lateral view of a mass in the body of the stomach in a dog. Note the increased opacity in the craniodorsal abdomen, with distortion of the fundic gas shadow and caudal displacement of the colon.
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8.9 Lateral and VD radiographs of an extensive pancreatic mass in a cat. The duodenum is displaced laterally and the small and large intestines are displaced caudally and ventrally. The mass is poorly defined because of a local peritonitis.
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8.10 Lateral and VD radiographs of a large mass in the right kidney of a cat. There is marked ventral, caudal and leftward displacement of all peritoneal organs.
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8.11 Lateral and VD radiographs of a left adrenal gland mass in a dog. Note the increased opacity in the craniodorsal abdomen with ventral and rightward displacement of the abdominal viscera.
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8.12 Lateral radiograph demonstrating a pyometra in a dog. Separation of the colon and bladder can be seen, with coiled distended tubular structures extending cranially.
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8.13 Lateral and VD radiographs of an ovarian cyst in a bitch, which has displaced the intestines dorsally, cranially and caudally. Compare the appearance with that in Figure 8.10 , where an equally large renal (i.e. retroperitoneal) mass has displaced the viscera ventrally.
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8.14 Lateral view of the caudal abdomen of a dog with a paraprostatic cyst, which has displaced the bladder cranioventrally. Note the ‘eggshell’ mineralization of the caudoventral part of the cyst.
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8.15 Aggressive sublumbar carcinoma, displacing the colon ventrally and the bladder and small intestines cranially. There is an extensive periosteal reaction along the ventral surfaces of the vertebrae, with amorphous mineralization within the body of the mass.
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8.16 Colour flow Doppler ultrasonogram of an adrenal gland mass invading the caudal vena cava in a dog.
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8.17 Ultrasonographic appearance of a heterogenous liver mass in a dog.
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8.18 Ultrasonographic appearance of a polycystic feline kidney. There is loss of the normal kidney architecture due to multiple variably sized cysts.
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8.19 Ultrasonogram of a cavitary liver mass in a dog.
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8.20 Ultrasonographic appearance of an encapsulated abscess. Echogenic fluid can be identified centrally.
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8.21 Ultrasound-guided tissue core biopsy of the left kidney of a dog.
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