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The adrenal glands
/content/chapter/10.22233/9781910443248.chap13
The adrenal glands
- Author: Catherine Sturgeon
- From: BSAVA Manual of Canine and Feline Abdominal Surgery
- Item: Chapter 13, pp 244 - 254
- DOI: 10.22233/9781910443248.13
- Copyright: © 2015 British Small Animal Veterinary Association
- Publication Date: November 2015
Abstract
The increasing availability of advanced imaging techniques coupled with more veterinary surgeons (veterinarians) developing and refining the skills of ultrasonography has meant that adrenal masses are more frequently diagnosed and their removal contemplated. This chapter considers adrenalectomy, imaging, pre- and postoperative considerations, intraoperative management and the technique in cats. Practical tips and editors’ notes are highlighted throughout. Operative technique: Adrenalectomy including venotomy of the caudal vena cava.
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Figures
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13.1
Anatomy of the adrenal glands and surrounding structures. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. © 2015 British Small Animal Veterinary Association
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13.1
Anatomy of the adrenal glands and surrounding structures. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
/content/figure/10.22233/9781910443248.chap13.ch13fig4
13.4
A 6-year-old Poodle bitch with pituitary-dependent hyperadrenocorticism. Note the abdominal distension, muscle wasting, alopecia and thin skin. (Reproduced from the
BSAVA Manual of Canine and Feline Endocrinology, 4th edn
) © 2015 British Small Animal Veterinary Association
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13.4
A 6-year-old Poodle bitch with pituitary-dependent hyperadrenocorticism. Note the abdominal distension, muscle wasting, alopecia and thin skin. (Reproduced from the
BSAVA Manual of Canine and Feline Endocrinology, 4th edn
)
/content/figure/10.22233/9781910443248.chap13.ch13fig7
13.7
An ultrasound image of an adrenal gland with normal dimensions. (Courtesy of J Shimali) © 2015 British Small Animal Veterinary Association
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13.7
An ultrasound image of an adrenal gland with normal dimensions. (Courtesy of J Shimali)
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13.8
(a) CT image showing an adrenal mass invading the renal vein (arrowed). (b) CT image showing extensive abdominal metastases (arrowed) from a phaeochromocytoma.
© 2015 British Small Animal Veterinary Association
(a, courtesy of F McConnell)
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13.8
(a) CT image showing an adrenal mass invading the renal vein (arrowed). (b) CT image showing extensive abdominal metastases (arrowed) from a phaeochromocytoma.
(a, courtesy of F McConnell)
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13.10
Haemostatic surgical clips. © 2015 British Small Animal Veterinary Association
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13.10
Haemostatic surgical clips.
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13.11
Harmonic® scalpel. (© Ethicon Inc.) © 2015 British Small Animal Veterinary Association
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13.11
Harmonic® scalpel. (© Ethicon Inc.)
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The adrenal gland is exposed by carefully dissecting the peritoneum and fatty tissue away from the gland.
The adrenal gland is exposed by carefully dissecting the peritoneum and fatty tissue away from the gland. © 2015 British Small Animal Veterinary Association
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The adrenal gland is exposed by carefully dissecting the peritoneum and fatty tissue away from the gland.
The adrenal gland is exposed by carefully dissecting the peritoneum and fatty tissue away from the gland.
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The phrenicoabdominal vein is dissected from surrounding structures and attachments. Vessels are ligated with haemoclips prior to being divided.
The phrenicoabdominal vein is dissected from surrounding structures and attachments. Vessels are ligated with haemoclips prior to being divided. © 2015 British Small Animal Veterinary Association
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The phrenicoabdominal vein is dissected from surrounding structures and attachments. Vessels are ligated with haemoclips prior to being divided.
The phrenicoabdominal vein is dissected from surrounding structures and attachments. Vessels are ligated with haemoclips prior to being divided.
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The adrenal gland is then removed and the surgical site examined for haemorrhage.
The adrenal gland is then removed and the surgical site examined for haemorrhage. © 2015 British Small Animal Veterinary Association
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The adrenal gland is then removed and the surgical site examined for haemorrhage.
The adrenal gland is then removed and the surgical site examined for haemorrhage.
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Removal of a left-sided adrenal mass with a thrombus extending into the vena cava. Rummel tourniquets are placed and a venotomy is made into the vena cava.
Removal of a left-sided adrenal mass with a thrombus extending into the vena cava. Rummel tourniquets are placed and a venotomy is made into the vena cava. © 2015 British Small Animal Veterinary Association
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Removal of a left-sided adrenal mass with a thrombus extending into the vena cava. Rummel tourniquets are placed and a venotomy is made into the vena cava.
Removal of a left-sided adrenal mass with a thrombus extending into the vena cava. Rummel tourniquets are placed and a venotomy is made into the vena cava.
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The thrombus and adrenal mass are removed en bloc. The Satinsky clamp is placed over the venotomy site, allowing restoration of blood flow once the Rummel tourniquets have been removed.
The thrombus and adrenal mass are removed en bloc. The Satinsky clamp is placed over the venotomy site, allowing restoration of blood flow once the Rummel tourniquets have been removed. © 2015 British Small Animal Veterinary Association
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The thrombus and adrenal mass are removed en bloc. The Satinsky clamp is placed over the venotomy site, allowing restoration of blood flow once the Rummel tourniquets have been removed.
The thrombus and adrenal mass are removed en bloc. The Satinsky clamp is placed over the venotomy site, allowing restoration of blood flow once the Rummel tourniquets have been removed.