SESSION
SPONSORED
BY
He Ate What????
GI Radiology
Dr. LeeAnn Pack
Dipl. AVCR
Esophageal Foreign Bodies
 Soft Tissue, Mineral or Metal density
 Common sites:
– thoracic inlet, heart base, LES
 Radiographic appearance
– focal distention of the esophagus
• pneumomediastinum, pleural effusion,
mediastinal fluid, strictures
Fish Hook with String
Stomach - Anatomy
 Cardia, fundus, body, pyloric antrum,
pyloric canal
 Where are they located???
 Air and fluid are our friends!
– Left lateral - air in pylorus, fluid in fundus
– Right lateral - air in fundus, fluid in pylorus
– VD – Gas in body and pyloric antrum
– DV – Gas in the fundus
The Normal Stomach
FB in pylorus? Um no
See how you can move things
around?
The Gastrogram!
 Patient must be fasted!
 Contrast Media
– Barium suspension (5-8ml/lb)
– Organic Iodine (if suspect perforation)
– Room air
 All are administered by orogastric tube
The Gastrogram!
 Double contrast study - 1-2ml/lb Barium
suspension followed by 5-10ml/lb of
room air
 All 4 views are made (VD, DV, both
laterals) usually
Gastric Dilation/Volvulus
 Emergency
 Must take both lateral views
–
–
–
–
stomach distended with gas and fluid
pylorus displaced dorsally and to left
compartmentalization
+/- splenomegaly, +/- hypovolemic
changes
 Gastric distention without torsion has
normal location
Popeye Arm = GDV
GDV
GDV with paralytic ileus
GDV – note air in esophagus
Gastric Distension (Bloat)
 Stomach remains in the normal position
but is significantly distended
 Often seen after eating abnormal
amounts of food
 Usually just time to treat – frequent
walks - monitor progression of ingesta
Gastric Distension
Gastric Foreign Body
 May see on survey films
– Bones, fish hooks, needles
 FB’s not in the pylorus appear as filling
defects
 Porous FB (cloth) retain contrast
 Room air can be used
– Don’t be afraid to repeat rads
in few hours
Gastric FB
Dummy
Rock FB
Sock FB
 In 2007 VPI Pet insurance paid out how
much money in claims for FB ingestion?
– A. $170,000
– B. $ 580,000
– C. $1.5 million
– D. $ 3.2 million
1- confident 2 – have good idea 3- just guessing
 In 2007 VPI Pet insurance paid out how
much money in claims for FB ingestion?
– A. $170,000
– B. $ 580,000
– C. $1.5 million
– D. $ 3.2 million
Bones most common – others needles, wood, rawhides
and fish hooks
Small Intestine - Anatomy
 Duodenum, jejunum, ileum
 Jejunum and ileum are mobile
 Normal SI diameter is 3 times the width
of the last rib
 Bowel wall thickness should not be
“guestimated” on survey radiographs
Ileus
 Mechanical (Obstructive)
– localized
– moderate to severe distention
• greater than 3 rib widths (dog)
– non-uniform distention
– “stacking” and “hair-pin” turns
– Causes: FB, strictures, granulomas,
neoplasia, enteroliths, trichobezoars,
parasites, adhesions
What is too big?




Dog = > 3 rib widths
Cat = > 12mm
Ferrets = > 5-7mm
Foals = > length of L1
Lion ate a garden hose
Obstructive Ileus
Obstructive Ileus – Corn Cob
Corn Cob
Obstructive Ileus
Fairly Caudal Obstruction
Ileus
 Functional (Paralytic)
– Not as common
– Generalized, moderate, uniform distention
– See with:
•
•
•
•
peritonitis, enteritis
pain, dysautonomia
stress, spinal trauma
post-surgery
Mesenteric Volvulus
 Mesenteric Root Torsion
– Occulsion of Cranial mesenteric artery
 Emergency
 Large breed dogs
Mesenteric Root Torsion
Linear Foreign Body
 Can often be seen on survey films
 Centralization and clumping of bowel
 Plication of bowel loops (especially in
the duodenum)
 Emergency
 FB stuck orad commonly
– Dogs = most in stomach, duodenum
– Cat = look for something under tongue
Linear Foreign Body
 In cats 90% are thread
 In dogs, linear FB are about twice as
fatal
– More severe bowel lacerations
– Plastic, ingested fabric
– 25% have concurrent intussusception
– Older
Reminder of Normal
Plicated Small Intestines
Linear FB
Cat – string under tongue
Linear FB
Shoe String Bowel
Foreign objects/material in GI
tract
 May not cause obstructive ileus
 Can do repeat rads to follow progress
Midnight 
8am 
Do you see the FB?
What is the FB and would you
take it out?
Rocks and Needle…they
passed
Colon FB
Free Air
Pneumoperitoneum
 Etiologies
– Penetrating external wound
• Trauma
• Iatrogenic
– Abdominocentesis
– Laparotomy - may persist for time after surgery
– Rupture of internal viscous
• Gastrointestinal tract most common
– Most air originates from stomach and colon rupture
Pneumoperitoneum
 Roentgen signs
– Enhanced visceral/serosal margin detail
– Visualization of abdominal structures not
normally seen
– Intra-abdominal gas opacities not
conforming to or visualized within GI
structures
• Often looks like small little gas bubbles
Improved Serosal Surface
Detail
Free Peritoneal Air
 Large to moderate
volume
 Caudal surface of
diaphragm
 Enhanced organ
outline
Can you see the free air?
Pneumoperitoneum
 Diagnosis
– Positional radiography = horizontal beam
• Position animal to allow gas to accumulate in
area where easily visualized
• Take advantage of gravity to localize gas
– Elevated Dorsal recumbency: accumulation of gas in area
of liver, diaphragm, and falciform fat
– Left lateral recumbency: accumulation of gas in right
cranial quadrant away from fundus of stomach
» Air seen against the liver
Elevated Dorsal Recumbency
10 yo cat not eating and
salivating
Puppy ate an Ear Bud
A Proud Canadian Dog
4 yo GRet. Vomiting
Dog ate Gorilla Glue
6 yo vomiting cat
Pony Tail Holders
instyle.com
He Ate What?
3 mo M Lab puppy vomiting
Baby Bottle Nipple
Had stomach biopsy – 7 days
later still very sick
4 mo M Lab - vomiting
Questions?
 Everything that goes in must come
out...one way or another...
SESSION
SPONSORED
BY