Page 342 - Feline diagnostic imaging

350 22 Gastrointestinal Disease

(a) (b)

(c) (e)

(d)

Figure 22.3 (a) Esophageal masses in an 11-year-old domestic shorthair with a one-month history of regurgitation. An irregular
air-filled esophageal lumen (arrows) is visible in the cranial thorax. Esophagoscopy revealed two extensive masses. Biopsy showed
pyogranulomatous esophagitis likely secondary to herpesvirus-1. (b) Lateral projection of the thorax of an 8-year-old cat with a
four-month history of anorexia and vomiting. A fluid opacity (arrow) can be seen in the caudal thorax likely associated with the
esophagus. An esophageal feeding tube is present in the esophagus with the tip at the cranial one-third of the mass. (c) Ventrodorsal
projection showing that the mass is located in the midline (arrows). (d) Iodinated contrast medium was administered and showed
irregularity of the esophageal mucosa. Because contrast did not flow past the cranial aspect of the mass when first injected, the
catheter was advanced into the stomach. The wall of the stomach (S) appears irregular and thickened and the kidneys (K) appear
abnormally shaped, suggesting infiltrative disease involving multiple organs. (e) Ventrodorsal projection.

cases, the esophagus is not seen but there is widening of determine the shape of the foreign body and to better
the cranial mediastinum. Aspiration is a frequent compli- determine the location of a suspected foreign body. Some
cation so it is important to look for any evidence of alveolar objects may be visible because of intraluminal gas sur-
disease such as air bronchograms, a silhouette sign or fluffy rounding them. Objects at the pylorus or in the intestines
coalescing opacities. With PRRA on the ventrodorsal (VD) could result in mechanical obstruction visible radio-
projection, there may be displacement of the trachea to the graphically (Figure 22.6). Inquiry should be made to
left by the right aortic arch that forms a dense opacity. If determine any medications that may have been given to
the diagnosis is unclear, an esophagram can be done to the cat because some medications, such as Pepto‐Bismol,
demonstrate the esophageal enlargement. are radiopaque.
When a gastric foreign body is suspected but is not seen
on survey radiographs, administer a small amount of bar-
22.3 Gastric Disorders ium (10–20 cc) to try coat the object. Make sure to expose
all four projections (VD, dorsoventral [DV], right lateral,

22.3.1 Gastrointestinal Foreign Bodies left lateral). If results are negative, administer a full dose of
barium and look for any filling defects. If nothing is appar-
Some gastrointestinal foreign bodies [1,3,7] are radio- ent, proceed to full gastrointestinal (GI) series. A foreign
paque and identifiable with some imagination. At least object may be further down the tract. Additionally, it is not
two orthogonal projections should be made to help uncommon to see retention of barium in films made later