1. Imaging the Intestine Tony Pease, DVM, MS
Assistant Professor of Radiology
North Carolina State University

2. Reading
Thrall
Chapters 48-49

3. Small intestine Small intestine Seen normally with gas or fluid
Cannot tell bowel wall thickness without contrast medium present

4. Ileus The failure of movement Divided into functional and mechanical
Problem with motility due to any cause
Mechanical
Physical obstruction impeding flow

5. Functional
Diffuse SI fluid

6. Remember, large animals stand!
presumed anterior enteritis in a arab foal

7. Mechanical
Cloth foreign body in stomach/duodenum

9. Small colon impaction
3 day old foal, 360 colon torsion
859028

10. Don’t forget foreign bodies
Pine cone

12. Remember!! If you can’t see the foreign body The question to ask
Try another view
The question to ask
Is the small intestine bigger than it should be?
Cat < 13 mm diameter
Dog < the size of the colon

13. Rock

14. Not always opaque!

15. A Cork

16. Linear foreign bodies
Causes plication
Crescent shaped
+/- peritonitis

17. Positioning
Horizontal Beam
Vertical Beam

18. Linear foreign body
DSH Linear foreign body

19. Linear foreign body

20. The second half of contrast media
Evaluate the small intestine
Can see flocculation
Fimbriation (wispiness)

21. Flocculation
Occurs with mucous or hemorrhage

22. Fimbriation

23. Patterns with contrast media
Infiltrative bowel disease
Linear foreign bodies
Obstruction
Annular
Intraluminal

24. “Thumbprinting” Regularly spaces divots Inflammation/infiltration
Lymphocytic-plasmocytic enteritis
Parvovirus
Lymphoma
Eosinophilic infiltration

25. Thumbprinting
30 min

26. Infiltrative disease

27. Linear foreign body

28. Chronic partial bowel obstruction
Can get quite large and distended
Specific syndrome in Saimese
Distal ileal adenocarcinoma
Generally the mass is palpable

29. Partial obstruction

30. Chronic annular mass
Lymphoma or adenocarcinoma

31. Intraluminal object With contrast medium – filling defect
Even if radio-opaque on survey

32. Small intestine Lesion can be seen on radiograph Ultrasound
Needs to be large
Generally see effect of lesion
Ultrasound
Can see the lesion better
Eccentric vs concentric
Loss of wall layering

33. Small intestine

34. Can also see foreign bodies

35. What about equine?

36. Can use ultrasound also
Usually < 5 mm thick
If > 5 cm diameter = obstruction

37. Normal small intestine

38. Distended small intestine

39. Remember ultrasound’s benefit

40. What about the colon? In small animal Colonic neoplasia Polyps
Not many things happen to colon
Colonic neoplasia
Adenoma vs. adenocarcinoma
Polyps
Stricture

41. Positive contrast medium
Use a foley catheter
Inject 7-17 ml per kilogram
Multiple views
Need an enema first
Uses to help differentiate from small intestine

44. Negative contrast Inject room air into colon Helps define masses
Risk of air embolism
Do not do if suspect colitis
Helps define masses

46. Colonic ultrasound Gas is a big problem Enema is preferred
Generally looking at lymph nodes

47. Colon neoplasia

48. Conclusion Thickness of GI If suspect mechanical obstruction
Need contrast medium
If suspect mechanical obstruction
Surgery
If you are not sure
Take another view
Recommend ultrasound

49. Questions?