Radiographic interpretation of the abdomen

Angela M. Lennox

doi:10.22233/9781910443163.7

British Small Animal Veterinary Association , 84 (2013); https://doi.org/10.22233/9781910443163.7

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Radiographic interpretation of the abdomen

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Author: Angela M. Lennox
From: BSAVA Manual of Rabbit Surgery, Dentistry and Imaging
Item: Chapter 7, pp 84 - 93
DOI: 10.22233/9781910443163.7
Copyright: © 2013 British Small Animal Veterinary Association
Publication Date: January 2013

Abstract

Many indications for abdominal radiography in the rabbit are similar to those in other species, and can be inferred from history (e.g. straining to urinate, haematuria), physical examination findings (e.g. abdominal pain, palpable gas accumulation, abdominal masses) or other supportive laboratory diagnostics (e.g. biochemistry, urinalysis). This chapter explores radiographic techniques, interpretation and specific conditions.

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Figures

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7.1

Lateral and VD views of the abdomen of a normal 1.4 kg intact female rabbit. (Reprinted from Capello and Lennox (2008) with permission of John Wiley & Sons) © 2013 British Small Animal Veterinary Association

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7.1 Lateral and VD views of the abdomen of a normal 1.4 kg intact female rabbit. (Reprinted from Capello and Lennox (2008) with permission of John Wiley & Sons)

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7.2

Computed (digital) radiography was used to produce lateral and VD views of the abdomen of a normal 1.4 kg intact male rabbit. Note the differences in contrast and greyscale compared with traditional film images. DICOM (digital imaging and communications in medicine) viewers allow measurement of organ size; in this rabbit the right kidney is 2.5 × 1.5 cm, and the left kidney is 2.8 × 1.9 cm. (Courtesy of Vittorio Capello) © 2013 British Small Animal Veterinary Association

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7.2 Computed (digital) radiography was used to produce lateral and VD views of the abdomen of a normal 1.4 kg intact male rabbit. Note the differences in contrast and greyscale compared with traditional film images. DICOM (digital imaging and communications in medicine) viewers allow measurement of organ size; in this rabbit the right kidney is 2.5 × 1.5 cm, and the left kidney is 2.8 × 1.9 cm. (Courtesy of Vittorio Capello)

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7.3

Computed (digital) radiography was used to obtain a DV radiograph of the rabbit shown in Figure 7.2 . This position is suboptimal because the pelvic limbs are not extended as in the VD view. However, this technique is useful for monitoring changes in the GI tract. In this case, the rabbit is healthy. Note that (a) and (b) show the same radiograph, before and after adjustment of the greyscale. Correct computer processing of digital images is important and can greatly affect visualization and diagnosis. (Courtesy of Vittorio Capello) © 2013 British Small Animal Veterinary Association

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7.3 Computed (digital) radiography was used to obtain a DV radiograph of the rabbit shown in Figure 7.2 . This position is suboptimal because the pelvic limbs are not extended as in the VD view. However, this technique is useful for monitoring changes in the GI tract. In this case, the rabbit is healthy. Note that (a) and (b) show the same radiograph, before and after adjustment of the greyscale. Correct computer processing of digital images is important and can greatly affect visualization and diagnosis. (Courtesy of Vittorio Capello)

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7.4

Depending on temperament or level of debilitation of the rabbit, dorsoventral radiographs of the abdomen may be obtained without restraint. While positioning is not ideal, evaluation of the GI tract is possible. (Courtesy of Vittorio Capello) © 2013 British Small Animal Veterinary Association

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7.4 Depending on temperament or level of debilitation of the rabbit, dorsoventral radiographs of the abdomen may be obtained without restraint. While positioning is not ideal, evaluation of the GI tract is possible. (Courtesy of Vittorio Capello)

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7.5

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7.5 Lateral view of an obese rabbit, demonstrating cranial displacement of most of the GI tract by abdominal fat. (© John Chitty)

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7.6

(a,b) Lateral and VD views of the abdomen of a dehydrated anorexic rabbit with RGIS. The stomach is enlarged, filled with ingesta and rounded in appearance. There is evidence of intestinal and caecal gas. (c,d) The same rabbit 2 hours after initiation of treatment, which included analgesics and intravenous fluid administration. The clinical condition had not deteriorated. A slight reduction in size of the stomach indicates that the condition is not worsening, and surgical intervention is probably not indicated. The rabbit went on to recover fully; the cause of the RGIS was unknown. (© Angela Lennox) © 2013 British Small Animal Veterinary Association

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7.6 (a,b) Lateral and VD views of the abdomen of a dehydrated anorexic rabbit with RGIS. The stomach is enlarged, filled with ingesta and rounded in appearance. There is evidence of intestinal and caecal gas. (c,d) The same rabbit 2 hours after initiation of treatment, which included analgesics and intravenous fluid administration. The clinical condition had not deteriorated. A slight reduction in size of the stomach indicates that the condition is not worsening, and surgical intervention is probably not indicated. The rabbit went on to recover fully; the cause of the RGIS was unknown. (© Angela Lennox)

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7.7

(a) Lateral view of the abdomen of a depressed, anorexic and dehydrated rabbit with severe gastric and caecal gas accumulation. The stomach is very large and round in appearance, and displaces the gas-filled caecum caudally. (b) Lateral radiograph of the same rabbit 8 hours after medical treatment, which included intravenous fluid administration, analgesia and administration of food via a nasogastric tube (visible in the radiograph). The severity of the initial condition suggested that surgical intervention might have been warranted, but this was declined by the owner. The rabbit went on to recover fully with medical therapy alone. (Reprinted from Veterinary Clinics of North America: Exotic Pet Practice 13(3), 2010, with permission of Elsevier) © 2013 British Small Animal Veterinary Association

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7.7 (a) Lateral view of the abdomen of a depressed, anorexic and dehydrated rabbit with severe gastric and caecal gas accumulation. The stomach is very large and round in appearance, and displaces the gas-filled caecum caudally. (b) Lateral radiograph of the same rabbit 8 hours after medical treatment, which included intravenous fluid administration, analgesia and administration of food via a nasogastric tube (visible in the radiograph). The severity of the initial condition suggested that surgical intervention might have been warranted, but this was declined by the owner. The rabbit went on to recover fully with medical therapy alone. (Reprinted from Veterinary Clinics of North America: Exotic Pet Practice 13(3), 2010, with permission of Elsevier)

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7.8

(a,b) Lateral and DV views of the abdomen, demonstrating a mineralized density that was identified as a calcified necrotic lipoma and was successfully removed at surgery. (a,b © John Chitty) (c) Lateral view of the abdomen of a different rabbit, showing a larger mineralized mass. This was identified as an abscess and removed surgically (d). (c,d courtesy of Frances Harcourt-Brown) © 2013 British Small Animal Veterinary Association

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7.8 (a,b) Lateral and DV views of the abdomen, demonstrating a mineralized density that was identified as a calcified necrotic lipoma and was successfully removed at surgery. (a,b © John Chitty) (c) Lateral view of the abdomen of a different rabbit, showing a larger mineralized mass. This was identified as an abscess and removed surgically (d). (c,d courtesy of Frances Harcourt-Brown)

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7.9

Lateral view of the abdomen of a rabbit with caecal impaction. Note the accumulation of round dense material of variable size in the enlarged caecum, which occupies most of the abdomen. (© Angela Lennox) © 2013 British Small Animal Veterinary Association

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7.9 Lateral view of the abdomen of a rabbit with caecal impaction. Note the accumulation of round dense material of variable size in the enlarged caecum, which occupies most of the abdomen. (© Angela Lennox)

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7.10

Lateral view of portions of the abdomen of a female rabbit. Note the multiple focal mineralized lesions associated with the liver. These lesions have been described in other rabbits following hepatic coccidiosis. They were an incidental finding. (Courtesy of Frances Harcourt-Brown) © 2013 British Small Animal Veterinary Association

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7.10 Lateral view of portions of the abdomen of a female rabbit. Note the multiple focal mineralized lesions associated with the liver. These lesions have been described in other rabbits following hepatic coccidiosis. They were an incidental finding. (Courtesy of Frances Harcourt-Brown)

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7.11

Bilateral nephrolithiasis and unilateral (left) ureterolithiasis in a dehydrated 5-year-old female rabbit. Both views are essential for localization of the uroliths. Further diagnostic imaging would include ultrasonography and contrast urography. (Courtesy of Vittorio Capello) © 2013 British Small Animal Veterinary Association

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7.11 Bilateral nephrolithiasis and unilateral (left) ureterolithiasis in a dehydrated 5-year-old female rabbit. Both views are essential for localization of the uroliths. Further diagnostic imaging would include ultrasonography and contrast urography. (Courtesy of Vittorio Capello)

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7.12

Lateral and VD views of the abdomen of a female rabbit with hypercalciuria. Note the accumulation of radiodense material in the bladder. (© Angela Lennox) © 2013 British Small Animal Veterinary Association

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7.12 Lateral and VD views of the abdomen of a female rabbit with hypercalciuria. Note the accumulation of radiodense material in the bladder. (© Angela Lennox)

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7.13

Lateral and VD views of a 9-year-old spayed female rabbit with chronic hypercalciuria. Note the abnormal dilation of the bladder, and accumulations of urine and sludge of varying densities. (© Angela Lennox) © 2013 British Small Animal Veterinary Association

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7.13 Lateral and VD views of a 9-year-old spayed female rabbit with chronic hypercalciuria. Note the abnormal dilation of the bladder, and accumulations of urine and sludge of varying densities. (© Angela Lennox)

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7.14

Lateral and VD views of the abdomen of a female rabbit with multiple cystoliths, including one very large and multiple small stones. The metal densities are haemostatic clips placed on the ovarian pedicles during ovariovaginectomy (OVV). In this animal, OVV was performed at a young age, before enlargement of the uterus; therefore, the haemoclips appear further caudally than expected. (© Angela Lennox) © 2013 British Small Animal Veterinary Association

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7.14 Lateral and VD views of the abdomen of a female rabbit with multiple cystoliths, including one very large and multiple small stones. The metal densities are haemostatic clips placed on the ovarian pedicles during ovariovaginectomy (OVV). In this animal, OVV was performed at a young age, before enlargement of the uterus; therefore, the haemoclips appear further caudally than expected. (© Angela Lennox)

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7.15

Lateral and VD views of a 9-year-old female rabbit with hypercalciuria and inguinal herniation of the urinary bladder. The bladder was readily palpable under the skin in the inguinal region, and gentle palpation caused expression of urine. The presence of mineral helped to localize the urinary bladder outside the margin of the peritoneal cavity on the lateral view. (© Angela Lennox) © 2013 British Small Animal Veterinary Association

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7.15 Lateral and VD views of a 9-year-old female rabbit with hypercalciuria and inguinal herniation of the urinary bladder. The bladder was readily palpable under the skin in the inguinal region, and gentle palpation caused expression of urine. The presence of mineral helped to localize the urinary bladder outside the margin of the peritoneal cavity on the lateral view. (© Angela Lennox)

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7.16

(a) Lateral view of the abdomen of an intact female rabbit. Note the bladder (B), vagina (V) and portions of an enlarged, abnormal uterus (U). (b) At surgery, the vagina (V) can be seen in relation to the uterus (U). The urinary bladder is not visible in this image. (Courtesy of Vittorio Capello) © 2013 British Small Animal Veterinary Association

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7.16 (a) Lateral view of the abdomen of an intact female rabbit. Note the bladder (B), vagina (V) and portions of an enlarged, abnormal uterus (U). (b) At surgery, the vagina (V) can be seen in relation to the uterus (U). The urinary bladder is not visible in this image. (Courtesy of Vittorio Capello)

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7.17

(a) Lateral view of the abdomen of an intact female rabbit with a palpable mass in the caudoventral abdomen, and vaginal bleeding. Note the presence of a soft tissue mass with fine mineralization correlating with the palpation findings, and consistent with a uterine mass. (b) Uterine mass excised at surgery. (© Angela Lennox) © 2013 British Small Animal Veterinary Association

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7.17 (a) Lateral view of the abdomen of an intact female rabbit with a palpable mass in the caudoventral abdomen, and vaginal bleeding. Note the presence of a soft tissue mass with fine mineralization correlating with the palpation findings, and consistent with a uterine mass. (b) Uterine mass excised at surgery. (© Angela Lennox)