Abdominal Radiographs

Basic veterinary abdominal radiographic interpretation

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Abdominal Radiographs by Mind Map: Abdominal Radiographs

1. Signalment and History

1.1. gastrointestinal signs - vomiting, diarrhea, inappetence, tenesmus

1.2. known ingestion of radiopaque foreign body

1.3. abdominal pain

1.4. abdominal distention

1.5. weight loss

1.6. stranguria

2. Technically acceptable

2.1. orthogonal views

2.1.1. left lateral if concerned about pyloric outflow obstruction

2.2. Positioned appropriately

2.3. Proper exposure

3. Physical exam

3.1. palpable abdominal mass

3.2. pain on abdominal palpation

4. Problem List

5. Evaluate gastrointestinal tract

5.1. Size

5.1.1. Stomach enlarged (normal position)

5.1.1.1. Contains feed (granular material)

5.1.1.1.1. food bloat or normal post-prandial

5.1.1.2. Contains foreign material

5.1.1.2.1. Does the material remain within the pylorus on both laterals? pyloric outflow obstruction or anchored linear foreign body

5.1.2. Small intestinal Segmental enlargement

5.1.2.1. foreign material

5.1.2.1.1. positive for mechanical obstruction

5.1.2.2. no foreign material

5.1.2.2.1. likely still positive for mechanical obstruction (just can't see foreign body, mass, or intussusception). Ultrasound indicated

5.1.2.3. "bullet sign"

5.1.2.3.1. intussusception

5.1.3. Small intestinal Diffuse enlargement

5.1.3.1. Mild

5.1.3.1.1. diffuse gastroenteropathy

5.1.3.2. Severe

5.1.3.2.1. mesenteric torsion

5.1.3.2.2. functional ileus

5.2. Abnormal position

5.2.1. stomach

5.2.1.1. GDV

5.2.1.2. hiatal hernia

5.2.1.3. diaphragmatic hernia

5.2.2. small intestine

5.2.2.1. plication, bunching, eccentric gas bubbles

5.2.2.1.1. linear foreign body

5.3. Serosal detail

5.3.1. reduced

5.3.1.1. peritoneal effusion

5.3.1.2. poor body condition

5.3.1.3. pediatric animal

5.3.2. increased

5.3.2.1. pneumoperitoneum

6. Evaluate parenchymal organs

6.1. Normally not seen on radiographs

6.1.1. gallbladder, adrenal glands, pancreas, ovaries, uterus, lymph nodes, ureters

6.2. Small

6.2.1. microhepatia

6.2.1.1. portosystemic shunt, cirrhosis

6.2.2. renal degeneration (unilateral or bilateral)

6.2.3. hypoplasia

6.3. Enlarged with normal soft tissue opacity

6.3.1. neoplasia, cyst, hematoma, abscess, granuloma

6.3.1.1. Organ of origin based on mass location

6.3.1.1.1. Craniodorsal

6.3.1.1.2. Craniodorsal (left)

6.3.1.1.3. Cranioventral

6.3.1.1.4. Mid-ventral

6.3.1.1.5. Caudodorsal

6.3.1.1.6. Caudoventral

6.3.1.1.7. Retroperitoneal

6.4. Enlarged with gas opacity

6.4.1. abscess

7. Evaluate urogenital tract

7.1. Mineral opaque uroliths

7.1.1. urinary bladder, ureter, or kidney enlargement implies obstruction

7.2. reduced retroperitoneal detail

7.2.1. hemorrhage, urine, exudate (infection/inflammation)

7.3. Prostate

7.3.1. enlarged - castrated dog

7.3.1.1. likely carcinoma - mineralization increases likelihood

7.3.2. enlarged - intact dog

7.3.2.1. paraprostatic cyst

7.3.2.2. benign prostatic hypertrophy

7.3.2.3. prostatitis/prostatic abscess

7.4. Uteromegaly

7.4.1. pyometra

7.4.2. pregnancy

8. Evaluate extra-abdominal anatomy

8.1. visible portion of thorax

8.1.1. lungs

8.1.2. esophagus (mediastinum)

8.1.3. pleural space

8.1.4. diaphragm

8.2. limbs and vertebral column

8.2.1. aggressive bone lesion(s)

8.2.2. degenerative joint disease

8.2.3. trauma

9. Abdominal Point of Care Ultrasound

9.1. Evaluate peritoneal space

9.1.1. diaphragmaticohepatic window

9.1.2. splenorenal window

9.1.3. cystocolic window

9.1.4. hepatorenal window

9.1.5. ventral midline window

10. Other diagnostics

10.1. Point of Care bloodwork

10.2. Referral images

10.3. Urinalysis