9 & 10 - Gastrointestinal Principles I & II

What are causes of gastric distention?

Postprandial

Food or foreign material

GDV

Pyloric outflow or proximal duodenal obstruction

Gastric functional ileus

Aerophagia

Gastric distention causes caudal displacement of what 3 things?

Splenic head

Colon

Small Intestines

What radiographic sign is pathognomic for GDV?

Double bubble

Where is the pylorus located with GDV?

Dorsal & to the left

What is seen on radiographs with GDV?

Compartmentalization

Pylorus dorsal & left

Splenomegaly

Megaesophagus

Functional ileus

Thin caudal vena cava

Pneumoperitoneum, peritoneal effusion

What is seen with small intestinal ileus?

Distention of the SI tract

Failure of contents to be transported

What does normal jejunal content look like?

Soft tissue opaque or some gas content

How large is the small intestine normally in a dog?

How large is the small intestine normally in a cat?

What is mechanical small intestinal ileus?

Obstruction

What causes functional small intestinal ileus?

Paralytic blockage of movement of cotent

What are causes of functional ileus?

Enteritis

Periotonitis

Chronic mechanical obstruction

Parasympatholytics/Anesthesia

Ischemia

Dysautonomia

Toxicity

What is seen radiographically with functional ileus?

Generalized, mild dilation

Uniform diameter

What factors effect the radiogrphaic appearance of ileus?

Duration, Location & Type of obstruction

What is seen with mechanical ileus?

Various sizes of interstinal diamerter (mixed population)

2.4xs + the diameter of L5 vetrebral body

Distention proximal to obstruction

Parallell stacking

Radiopaque foreign body

What is parallel stacking?

Gas filled distended segment of bowel

What are the 3 location where mechanical ileus can occur?

Intraluminal

Mural

Extramural

What are examples of things that can cause intraluminal mechanical ileus?

FB

Parasites

What are examples of things that can cause mural mechanical ileus?

Tumor

Granuloma

What are examples of things that can cause extramural mechanical ileus?

Adhesions

Hernia

Tumor

What is done to treat functional ileus?

Medical management

(Sx if chronic or volvulus)

What is done to treat mechanical ileus?

Exploratory laparotomy

Medical management

What can be used for a compression study?

A wooden spoon

T/F - Linear FBs cause vomiting in dogs and cats

True

What is the anchor point of linear foreign bodies in a cat?

Tongue

What is the anchor point of linear foreign bodies in a dog?

Pylorus

Dogs/Cats typically have thin and threadlike material for linear FBs

Cats

Dogs/Cats typically have thicker textile material for linear FBs

Dogs

What is the plication pattern for linear FBs in cats?

Tight

What is the plication pattern for linear FBs in dogs?

Bunched loops

What does intestional torsion & volvulus result in?

Sepsis

Circulatory shock

Death

What is intestinal torsion?

Pathologic twisting of bowel along its longitudinal axis

What is intestinal volvulus?

Twisting of bowel around the mesenterid pedicle

What are general indications for abdominal contrast procedures?

Locate an organ

ID rupture/obsturction

Highligh structures in hollow organs

Evaluate basic functional information

What are 2 types of negative contrast media?

Air

Gas (O2, Nitrous oxide, CO2)

What are 2 types of positive contrast media?

Barium

Iodine

What do negative contrast mediums do?

Makes organ of interest more radiolucent

What are negative contrast studies used for?

Pneumogastrogram

Pneumocystogram

Pneumocolonogram

Double contrast studies

What do positive contrast mediums do?

Make organ of interest more radiopaque

What are barium sulfate contrast studies used for?

Esophagram

Gastrogram

Upper GI

Colonogram/barium enema

How can barium sulfate?

Per annum (anus)

Per os (mouth)

When should barium NOT be used?

If GI perforation is suspected

What are uses of iodinated contrast studies?

Excretory urogram/IV pyelogram

Cystogram

Retrograde Urethrogram/Vaginourethrogram

Fistulogram

Arthrogram

Myelogram

GI obstruction

When should ionic iodinated contrast NOT be used?

Intrathecally

High risk patients

What are the 6 Roentgen signs?

Size

Shape

Location

Number

Opacity

Margination

What are additional considerations with Roentgen signs?

Timing

Degree of opacification

Luminal diameter

Wall thickness

Filling defects

What are indications for upper GI contrast studies

If US & endoscopy is unavialbe

How long does it typically take liquid to be emptied from the stomach?

1-4 hours

Cats/Dogs have a faster gastric emptying

Cats (within 1 hour)

Iodinated contrast empties faster/slower than normal emptying

Faster

Emptying & transit times are faster/slower with barium soaked kibble

Slower

How much contrast should small dogs be given?

8-12 mL/kg

How much contrast should large dogs be given?

5-7 mL-kg

How should contrast be administered?

Orogastric tube

What are indications for a pneumocolonogram?

Differentiate small vs large intestines

Large bowel stricture or masses

What abnormality is seen in this image?

Gastric distention

What structure is highlighted in pink?

Cecum

What does this indicate?

Gastric Dilation & Volvulus

Which marker is highlighting the abnormality?

Yellow

What is the yellow marker indicating?

Some textile FB in the intestines

What abnormality is seen in this image? Point it out.

FB Obstruction

Is this functional or mechanical ileus?

Functional

What is the most likely cause of gas appearing like this? 1 yo FS Min Pin.

Linear foreign body

What is the most likely cause of this apperance? 1 yo FS DSH

Linear foreign body

What is seen in this radiograph generally?

Small intestinal plication

What causes this appearance?

Linear FB

Is this functional/mechanical ileus?

Functional

What is seen here after the barium study?

Chronic colonic torsion

What is seen in this radiograph?

Esophageal obstruction

What type of luminal defect is this?

Intraluminal

What type of luminal defect is this?

Mural

What type of luminal defect is this?

Extramural

What type of luminal defect is this?

Intraluminal

What type of luminal defect is pictured on the right? (Left is normal)

Mural

What type of luminal defect is this?

Extramural (dilation around obstruction)

What type of study is this?

Contrast study

What type of study is this?

Pneumocolonogram