Imaging of the gastrointestinal tract, liver and pancreas

Virginie Barberet

doi:10.22233/9781910443361-3e.3

British Small Animal Veterinary Association , 12 (2019); https://doi.org/10.22233/9781910443361-3e.3

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Imaging of the gastrointestinal tract, liver and pancreas

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Author: Virginie Barberet
From: BSAVA Manual of Canine and Feline Gastroenterology
Item: Chapter 3, pp 12 - 24
DOI: 10.22233/9781910443361-3e.3
Copyright: © 2020 British Small Animal Veterinary Association
Publication Date: November 2019

Abstract

There are various imaging modalities available for assessing the gastrointestinal (GI) tract, liver and pancreas. Ultrasonography is generally the imaging modality of choice. However, plain radiography can be very helpful in assessing the oesophagus and detecting specific GI diseases and computed tomography has proven very useful for assessing specific disorders of the liver and pancreas.

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Figures

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3.1

Lateral view of the neck of a dog with an extensive stick injury. The stick (arrowed) is poorly visible. There is a large amount of gas in the fascial planes of the neck and in the mediastinum outlining the tracheal wall. © 2020 British Small Animal Veterinary Association

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3.1 Lateral view of the neck of a dog with an extensive stick injury. The stick (arrowed) is poorly visible. There is a large amount of gas in the fascial planes of the neck and in the mediastinum outlining the tracheal wall.

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3.2

Right lateral view of the thorax of a dog with a gas-filled megaoesophagus. The dorsal and ventral oesophageal walls (arrowed) appear as thin converging soft tissue stripes. © 2020 British Small Animal Veterinary Association

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3.2 Right lateral view of the thorax of a dog with a gas-filled megaoesophagus. The dorsal and ventral oesophageal walls (arrowed) appear as thin converging soft tissue stripes.

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3.3

Right lateral view of the thorax of a dog with a megaoesophagus after positive contrast oesophagraphy. The oesophagus is severely dilated, inducing a ventral displacement of the trachea. © 2020 British Small Animal Veterinary Association

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3.3 Right lateral view of the thorax of a dog with a megaoesophagus after positive contrast oesophagraphy. The oesophagus is severely dilated, inducing a ventral displacement of the trachea.

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3.4

Transverse CT image (post-contrast soft tissue window) of a dog with a para-oesophageal abscess (arrowed) in the caudal mediastinum. The arrowhead indicates the oesophagus, which contains a small amount of air. © 2020 British Small Animal Veterinary Association

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3.4 Transverse CT image (post-contrast soft tissue window) of a dog with a para-oesophageal abscess (arrowed) in the caudal mediastinum. The arrowhead indicates the oesophagus, which contains a small amount of air.

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3.5

Right lateral view of the abdomen of a dog with gastric dilatation-volvulus. The stomach is severely gas-dilated and compartmentalized, with the pyloric antrum being located craniodorsally. Paralytic ileus (gas dilatation of the small intestines) and gas dilatation of the oesophagus are also visible. © 2020 British Small Animal Veterinary Association

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3.5 Right lateral view of the abdomen of a dog with gastric dilatation-volvulus. The stomach is severely gas-dilated and compartmentalized, with the pyloric antrum being located craniodorsally. Paralytic ileus (gas dilatation of the small intestines) and gas dilatation of the oesophagus are also visible.

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3.6

Right lateral view of the abdomen of a dog with carcinoma in the gastric body and pyloric antrum. The gastric wall is severely thickened and there is a soft tissue mass (arrowed) outlined by luminal gas. © 2020 British Small Animal Veterinary Association

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3.6 Right lateral view of the abdomen of a dog with carcinoma in the gastric body and pyloric antrum. The gastric wall is severely thickened and there is a soft tissue mass (arrowed) outlined by luminal gas.

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3.7

Right lateral view of the abdomen of a dog with an acute mechanical obstruction by a radiolucent foreign body (not visible). Some small intestinal loops are severely gas-dilated (arrowed) and the stomach is fluid-filled. © 2020 British Small Animal Veterinary Association

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3.7 Right lateral view of the abdomen of a dog with an acute mechanical obstruction by a radiolucent foreign body (not visible). Some small intestinal loops are severely gas-dilated (arrowed) and the stomach is fluid-filled.

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3.8

Left lateral view of the abdomen of a dog with chronic partial obstruction of a small intestinal loop. The affected loop is severely dilated and shows a gravel sign (arrowed). © 2020 British Small Animal Veterinary Association

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3.8 Left lateral view of the abdomen of a dog with chronic partial obstruction of a small intestinal loop. The affected loop is severely dilated and shows a gravel sign (arrowed).

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3.9

Ventrodorsal view of the abdomen of a dog with an ileocaecocolic intussusception. The intussuscepted bowel segment is outlined by luminal gas (arrowed). © 2020 British Small Animal Veterinary Association

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3.9 Ventrodorsal view of the abdomen of a dog with an ileocaecocolic intussusception. The intussuscepted bowel segment is outlined by luminal gas (arrowed).

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3.10

Left lateral view of the abdomen of a dog with a linear foreign body. The small intestine is severely plicated and some crescent-shaped gas bubbles are visible. Foreign material is also visible in the gas-filled pyloric antrum. © 2020 British Small Animal Veterinary Association

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3.10 Left lateral view of the abdomen of a dog with a linear foreign body. The small intestine is severely plicated and some crescent-shaped gas bubbles are visible. Foreign material is also visible in the gas-filled pyloric antrum.

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3.11

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3.11 Ventrodorsal view of the abdomen of a dog with mesenteric volvulus. The small intestinal loops are dilated with gas and show a hairpin aspect.

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3.12

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3.12 Lateral view of the abdomen of a cat with megacolon. The faeces are compacted and increased in opacity. There is a chronic sacral fracture (arrowed).

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3.14

Right lateral view of the abdomen of a dog with a partial intestinal obstruction due to a peach stone (24 hours after oral administration of barium sulphate). The pyloric antrum and duodenum are moderately dilated; an intraluminal filling defect with an ovoid shape is visible (arrowed). A small amount of barium is visible in the distal part of the small intestine and colon. © 2020 British Small Animal Veterinary Association

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3.14 Right lateral view of the abdomen of a dog with a partial intestinal obstruction due to a peach stone (24 hours after oral administration of barium sulphate). The pyloric antrum and duodenum are moderately dilated; an intraluminal filling defect with an ovoid shape is visible (arrowed). A small amount of barium is visible in the distal part of the small intestine and colon.

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3.15

(a) Ultrasonographic image of the duodenum of a dog. The wall shows a five-layered appearance (A = whole wall thickness), from internal to external: hyperechoic mucosal-luminal interface (arrowed), hypoechoic mucosa, hyperechoic submucosa, hypoechoic muscularis and hyperechoic serosa. (b) Higher magnification showing the five layers more clearly. © 2020 British Small Animal Veterinary Association

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3.15 (a) Ultrasonographic image of the duodenum of a dog. The wall shows a five-layered appearance (A = whole wall thickness), from internal to external: hyperechoic mucosal-luminal interface (arrowed), hypoechoic mucosa, hyperechoic submucosa, hypoechoic muscularis and hyperechoic serosa. (b) Higher magnification showing the five layers more clearly.

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3.17

Ultrasonographic image of a jejunal loop of a cat. The affected loop is severely dilated with fluid/ingesta due to a mechanical obstruction by a foreign body (arrowed) showing a hyperechoic curvilinear surface and strong acoustic shadowing. © 2020 British Small Animal Veterinary Association

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3.17 Ultrasonographic image of a jejunal loop of a cat. The affected loop is severely dilated with fluid/ingesta due to a mechanical obstruction by a foreign body (arrowed) showing a hyperechoic curvilinear surface and strong acoustic shadowing.

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3.18

Ultrasonographic image of an intussusception in a dog (arrowed). The affected loops show a multi-layered appearance (concentric rings) and mesenteric fat and blood vessels (in cross-section; arrowheads) are also present within the intussusception. © 2020 British Small Animal Veterinary Association

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3.18 Ultrasonographic image of an intussusception in a dog (arrowed). The affected loops show a multi-layered appearance (concentric rings) and mesenteric fat and blood vessels (in cross-section; arrowheads) are also present within the intussusception.

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3.19

Ultrasonographic image of a jejunal loop in a dog. Striations are visible within the mucosa as hyperechoic lines perpendicular to the lumen axis (arrowed). © 2020 British Small Animal Veterinary Association

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3.19 Ultrasonographic image of a jejunal loop in a dog. Striations are visible within the mucosa as hyperechoic lines perpendicular to the lumen axis (arrowed).

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3.20

Ultrasonographic image of a gastric ulcer in a dog previously treated with non-steroidal anti-inflammatory drugs. The gastric wall (in between calipers) is focally thickened (9.7 mm), and there is a thin hyperechoic line of gas tracking into the ulcer’s crater in the mucosa (arrowed). © 2020 British Small Animal Veterinary Association

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3.20 Ultrasonographic image of a gastric ulcer in a dog previously treated with non-steroidal anti-inflammatory drugs. The gastric wall (in between calipers) is focally thickened (9.7 mm), and there is a thin hyperechoic line of gas tracking into the ulcer’s crater in the mucosa (arrowed).

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3.21

Ultrasonographic image of gastric lymphoma in a dog. The gastric wall (in between callipers) is focally severely thickened (2.73 cm) and hypoechoic with a complete loss of layering. © 2020 British Small Animal Veterinary Association

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3.21 Ultrasonographic image of gastric lymphoma in a dog. The gastric wall (in between callipers) is focally severely thickened (2.73 cm) and hypoechoic with a complete loss of layering.

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3.22

Ultrasonographic image of intestinal lymphoma in a cat. The jejunal wall (in between calipers) is thickened (4.1 mm) due to a severe thickening of the muscularis layer (arrowed). Mucosal fibrosis is also seen (thin isoechoic line in the mucosa parallel to the submucosa). © 2020 British Small Animal Veterinary Association

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3.22 Ultrasonographic image of intestinal lymphoma in a cat. The jejunal wall (in between calipers) is thickened (4.1 mm) due to a severe thickening of the muscularis layer (arrowed). Mucosal fibrosis is also seen (thin isoechoic line in the mucosa parallel to the submucosa).

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3.24

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3.24 Transverse CT image (pre-contrast soft tissue window) of a dog with a diffuse colonic wall thickening due to neoplasia (arrowed).

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3.25

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3.25 Right lateral view of the abdomen of a dog with hepatic neoplasia. The stomach axis (indicated by a line) is severely displaced caudally.

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3.26

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3.26 Ultrasonographic image of an irregular hypoechoic lesion (arrowed) in the liver of a cat affected by lymphoma.

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3.27

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3.27 Ultrasonographic image of a large mixed echogenicity mass lesion (carcinoma) in the liver of a dog.

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3.28

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3.28 Ultrasonographic image of a severely dilated (7.7 mm) common bile duct in a cat affected by cholangiohepatitis.

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3.29

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3.29 Ultrasonographic image of a gall bladder mucocoele (arrowed).

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3.30

CT images (post-contrast soft tissue window) in (a) a transverse and (b) a dorsal plane of a dog with a right-divisional intra-hepatic portosystemic shunt (arrowed). The liver is very small. © 2020 British Small Animal Veterinary Association

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3.30 CT images (post-contrast soft tissue window) in (a) a transverse and (b) a dorsal plane of a dog with a right-divisional intra-hepatic portosystemic shunt (arrowed). The liver is very small.

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3.31

Ventrodorsal view of the abdomen of a dog with pancreatic neoplasia. The pyloroduodenal angle (arrowed) is widened due to a large pancreatic mass. The colon is also displaced caudally and to the left. © 2020 British Small Animal Veterinary Association

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3.31 Ventrodorsal view of the abdomen of a dog with pancreatic neoplasia. The pyloroduodenal angle (arrowed) is widened due to a large pancreatic mass. The colon is also displaced caudally and to the left.

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3.32

Ultrasonographic image of pancreatitis in a dog. The pancreas is mildly thickened (1.1 cm), hypoechoic with ill-defined margins and surrounded by hyperechoic fat. © 2020 British Small Animal Veterinary Association

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3.32 Ultrasonographic image of pancreatitis in a dog. The pancreas is mildly thickened (1.1 cm), hypoechoic with ill-defined margins and surrounded by hyperechoic fat.

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3.33

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3.33 Ultrasonographic image of pancreatic oedema in a dog. Note the hypoechoic stripes (arrowed) separating pancreatic lobulations.

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3.34

Transverse CT image (post-contrast arterial phase soft tissue window) of a dog with an insulinoma (arrowhead), which appears hyperattenuating to the rest of the left pancreatic limb (arrowed). © 2020 British Small Animal Veterinary Association

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3.34 Transverse CT image (post-contrast arterial phase soft tissue window) of a dog with an insulinoma (arrowhead), which appears hyperattenuating to the rest of the left pancreatic limb (arrowed).