Ultralyd, Abdomen

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Cecocolic intussusception. The cecum is intussuscepted into the lumen of the right ventral colon (long thick arrow). The cecal mucosal surface (arrowhead) and serosal surface (long thin arrow) are visible. Cranial is to the left in this image. This sonogram was obtained from right ventral abdomen with a curvilinear probe operating at 5.0 MHz at a depth of 17 cm.

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Cecal inversion. Cecal inversion images as edematous trilayer appearance of cecal wall (arrow) with inverted cecal apex (arrowhead). This lesion was present in the midventral abdomen of a weanling Quarterhorse foal with clinical signs of intermittent colic over 2 days. Cecal inversion was confirmed at surgery. This image was obtained from ventral abdomen with a curvilinear probe operating at 6.6 MHz at a depth of 13 cm

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Cecal impaction. Cecal impaction is usually diagnosed by rectal palpation, but may be visible ultrasonographically. The solid, intraluminal mass (long arrow) in the cecal base is visible adjacent to the fluid-filled cecal lumen (arrowhead) ventrally. The lateral cecal wall (short arrow) is visible. This sonogram was obtained from the right lateral abdomen with a curvilinear probe operating at 2.5 MHz at a depth of 23 cm.

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Lateral cecal vessels. A lateral vessel of the cecum (arrow) is visible just caudal to the costal arch on the right side of the abdomen. This sonogram was obtained from the right abdomen with a curvilinear probe operating at 6.6 MHz at a depth of 14 cm.

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Reperfusion injury after correction of colon torsion. This image is from a 12-year-old Thoroughbred mare 12 hours after surgical correction of a colon torsion. The right dorsal colon is imaged through the tenth ICS. Thickening of the colon wall from edema (cursors) is suggestive of significant reperfusion injury. A focally, extensive, hypoechoic area (arrowhead) within the submucosa is suggestive of a submucosal hematoma. Hematoma formation within the colon wall may indicate a coagulopathy associated with large and small vessel injury secondary to the colon torsion. The mare’s clinical status deteriorated and she was euthanized 6 hours after this ultrasound examination. This sonogram was obtained from the ventral abdomen with a curvilinear probe operating at 6.6 MHz at a depth of 15 cm.

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Colon torsion. Colon torsion may result in vascular compromise to the colon resulting in wall edema. This image is from a mare with colon torsion prior to surgical correction. The colon wall (arrow) is thickened and edematous. Luminal content (arrowhead) is visualized adjacent to the colon wall. This sonogram was obtained from the ventral abdomen with a curvilinear probe operating at 3.5 MHz at a depth of 11 cm.

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Colitis in adult. This image demonstrates a thickened and edematous colon wall from a horse with colitis. The corrugated appearance is sometimes seen with inflammatory processes. This image was obtained from the left abdomen with a curvilinear probe operating at depth of 14 cm.

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Colonic fluid. This image demonstrates increased fluid content in the lumen of the large colon. This image was obtained from the ventral abdomen with a curvilinear probe operating at 2.0 MHz at a depth of 20 cm. (Source: Image courtesy of Dr. Nathan Slovis, Hagyard Equine Medical Institute, Lexington, KY, USA.)

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Colitis from salmonellosis. This image demonstrates thickened and edematous colon in a horse diagnosed with salmonellosis. Note the visible fluid content in the lumen of the colon. This image was obtained from the left ventral abdomen with a curvilinear probe operating at 2.0 MHz at a depth of 12 cm. (Source: Image courtesy of Dr. Nathan Slovis, Hagyard Equine Medical Institute, Lexington, KY, USA.)

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Right dorsal colitis. This image is from the patient in Figure 24.34 1 month after initial presentation. The colon wall is thickened and echogenic (cursors). A thin, hypoechoic layer below the serosa is suggestive of edema. This is compatible with mucosal fibrosis of a healing mucosal ulceration of the right dorsal colon. This sonogram was obtained from the right abdomen with a curvilinear probe operating at 6.6 MHz at a depth of 21 cm

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Nephrosplenic entrapment. Nephrosplenic entrapment, or left dorsal displacement of the colon, images as colon in the nephrosplenic space. The colon obscures the ultrasound view of the left kidney and may force the spleen medial off the body wall. Pockets of free peritoneal fluid may be present around the spleen and colon. This sonogram was obtained from the left lateral abdomen with a curvilinear probe operating at 3.5 MHz at a depth of 18 cm.

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Right dorsal displacement of the colon. Right dorsal displacement of the colon may result in engorgement of the colonic vessels. Distended colonic vein (arrow) and artery (arrowhead) and medial mesocolon (long thin arrows) are imaged adjacent to the right body wall just ventral to the twelfth intercostal space. This sonogram was obtained from the right ventral abdomen with a curvilinear probe operating at 3.5 MHz at a depth of 17 cm.

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Colonic tympany. Colonic tympany images as horizontal reverberations from the colon wall. Causes for gas-distended colon include large intestinal displacement, impactions, or enteroliths. Gas-distended colon (thick arrow), the diaphragm (thin arrow), and the air-filled lung (arrowhead) are visible. This sonogram was obtained from left ventral abdomen with a curvilinear probe operating at 5.0 MHz at a depth of 12 cm.

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Normal left ventral colon. The multiple, short, curved echogenic structures represent the sacculations of the left ventral colon (LVC) as seen on the left side just ventral and medial to the ventral aspect of the spleen. This sonogram was obtained from the left ventral abdomen with a curvilinear probe operating at 6.6 MHz at a depth of 17 cm.

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Normal right dorsal colon. The curved, echogenic surface of the luminal material of the right dorsal colon (RDC) is imaged from the right side and is located ventral and medial to the right liver lobe. Ventral is to the left in this image. This sonogram was obtained from the right ventral abdomen with a curvilinear probe operating at 6.6 MHz at a depth of 15 cm.

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Jejunojejunal intussusception. These images demonstrate (A) cross-sectional and (B) longitudinal views of a jejunojejunal intussusception. A loop of jejunum telescoped into another loop of jejunum to create the classic “bull’s eye” appearance. Note the layers consisting of the outer intussusception (arrows) and inner intussusception (arrowheads) portions. The lesion can be transient and serial ultrasonographic examination may be needed to identify the lesion. These sonograms were obtained from the ventral abdomen with a micro-convex probe operating at 5.0 MHz at a depth of 6 cm.

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Jejunojejunal intussusception. These images demonstrate (A) cross-sectional and (B) longitudinal views of a jejunojejunal intussusception. A loop of jejunum telescoped into another loop of jejunum to create the classic “bull’s eye” appearance. Note the layers consisting of the outer intussusception (arrows) and inner intussusception (arrowheads) portions. The lesion can be transient and serial ultrasonographic examination may be needed to identify the lesion. These sonograms were obtained from the ventral abdomen with a micro-convex probe operating at 5.0 MHz at a depth of 6 cm.

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Lawsonia intracellularis infection. This image demonstrates marked thickening of the small intestinal wall in an 8-month-old Hanovarian colt with peripheral edema, hypoproteinemia, and hypoalbuminemia. The small intestinal changes (thickening of walls) were from proliferative enteropathy secondary to Lawsonia intracellularis infection. The arrowhead indicates the serosa and the arrow indicates the mucosal surface of the small intestinal wall. This sonogram was obtained from the ventral abdomen with a microconvex probe operating at 8.0 MHz at a depth of 12 cm.

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Small intestinal muscular hypertrophy. (A) This image demonstrates small intestinal muscular hypertrophy in a 7-year-old Thoroughbred stallion with clinical signs of recurrent colic secondary to non-strangulating obstruction of the small intestine. The arrows indicate the thickened, hypoechoic tunica muscularis layer of the small intestinal wall. (B) This image is another view of the same segment of small intestine showing a thick, hypoechoic layer representing hypertrophy of the tunica muscularis of the small intestine. These sonograms were obtained from left abdomen with a curvilinear probe operating at 3.5 MHz at a depth of 17 cm. (Source: Images courtesy of Dr. Sally Ness, Cornell University, Ithaca, NY, USA.)

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Small intestinal muscular hypertrophy. (A) This image demonstrates small intestinal muscular hypertrophy in a 7-year-old Thoroughbred stallion with clinical signs of recurrent colic secondary to non-strangulating obstruction of the small intestine. The arrows indicate the thickened, hypoechoic tunica muscularis layer of the small intestinal wall. (B) This image is another view of the same segment of small intestine showing a thick, hypoechoic layer representing hypertrophy of the tunica muscularis of the small intestine. These sonograms were obtained from left abdomen with a curvilinear probe operating at 3.5 MHz at a depth of 17 cm. (Source: Images courtesy of Dr. Sally Ness, Cornell University, Ithaca, NY, USA.)

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Enteritis in a foal. The small intestine has moderate fluid distention and varying degrees of motility. The walls are indistinct and echogenic consistent with inflammatory changes associated with enteritis. This sonogram was obtained from the ventral abdomen with a microconvex probe operating at 5.0 MHz at a depth of 10 cm.

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Enteritis in an adult horse. This image demonstrates thickened small intestine (arrowheads) associated with enteritis in an adult horse. Multiple echogenic foci within the small intestinal wall are consistent with inflammation. This sonogram was obtained from the left abdomen with a curvilinear probe operating at 6.0 MHz at a depth of 15 cm.

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Ileal impaction. This image demonstrates poorly motile, fluid-distended small intestine with a small amount of ventral sedimentation of particulate material in the caudal–ventral right abdomen. Ileal impaction was confirmed at surgery. This image was obtained from the ventral abdomen, right of midline, with a curvilinear probe operating at 3.5 MHz at a depth of 21 cm.

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Non-strangulating entrapment of small intestine. This image demonstrates marked fluid distension of small intestine (cursors) with poor motility and ventral sedimentation of particulate material in the left ventral abdomen of an adult Quarter Horse. Non-strangulating entrapment of the small intestine associated with large colon impaction was confirmed at surgery. This sonogram was obtained from the left inguinal region with a curvilinear probe operating at 2.5 MHz at a depth of 19 cm.

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Peritonitis with fecal contamination. This image demonstrates peritonitis associated with gastric rupture following small intestinal strangulation around the stalk of a lipoma. Numerous echogenic gas bubbles (arrows) are seen adherent to the intestinal serosa and parietal peritoneal surface. Note the thickened, indistinct intestinal wall of the compromised small intestine. This sonogram was obtained from the ventral abdomen with a curvilinear probe operating at 3.5 MHz at a depth of 15 cm.

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Lipoma with strangulated small intestine. (A,B) These images demonstrate strangulated, non-viable small intestine secondary to strangulation around the stalk of a lipoma. Note the thickened and echogenic intestinal walls (arrowheads) consistent with vascular engorgement and stasis and the indistinct serosal surfaces. These images were obtained from ventral abdomen, left of midline with a curvilinear probe operating at (A) 5.0 MHz at a depth of 12 cm and (B) 3.5 MHz at a depth of 20 cm.

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Lipoma with strangulated small intestine. (A,B) These images demonstrate strangulated, non-viable small intestine secondary to strangulation around the stalk of a lipoma. Note the thickened and echogenic intestinal walls (arrowheads) consistent with vascular engorgement and stasis and the indistinct serosal surfaces. These images were obtained from ventral abdomen, left of midline with a curvilinear probe operating at (A) 5.0 MHz at a depth of 12 cm and (B) 3.5 MHz at a depth of 20 cm.

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Lipoma with strangulated small intestine. (A,B) These images demonstrate strangulated, non-viable small intestine secondary to strangulation around the stalk of a lipoma. Note the thickened and echogenic intestinal walls (arrowheads) consistent with vascular engorgement and stasis and the indistinct serosal surfaces. These images were obtained from ventral abdomen, left of midline with a curvilinear probe operating at (A) 5.0 MHz at a depth of 12 cm and (B) 3.5 MHz at a depth of 20 cm.

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Small intestinal volvulus with ventral sedimentation. This image demonstrates fluid distended small intestine with ventral sedimentation of particulate material associated with small intestinal volvulus. Particulate matter has settled ventrally by gravity due to ileus and chronicity of the lesion. Ventral is to the left in this image. This image was obtained from the left abdomen with a curvilinear probe operating at 3.5 MHz at a depth of 15 cm.

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Lipoma. This 14-cm, discrete, hypoechoic mass (cursors) was located in the mid-ventral abdomen. Associated sonographic imaging showed dilated, poorly motile small intestine. Post-mortem examination confirmed this mass to be a lipoma strangulating a segment of small intestine. Imaging the lipoma in cases of small intestinal strangulation is rare. The finding of fluid-distended, nonmotile and/or thickened small intestine (see Figures 24.19 and 24.20) in an aged animal is the most consistent ultrasound finding with strangulating lipomas. This sonogram was obtained from the ventral abdomen with a curvilinear probe operating at 6.6 MHz at a depth of 14 cm.

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Small intestinal strangulation. This image from the patient in Figure 15 shows small intestinal distention from a mesenteric defect. Particulate matter (arrow) has settled to the ventral most aspect of the small intestine. This ventral sedimentation indicates the chronicity of the small intestinal damage. Small intestinal strangulation was confirmed at surgery. This sonogram was obtained from the left abdomen with a curvilinear probe operating at 3.5 MHz at a depth of 15 cm.

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Mesenteric defect. Fluid-distended, poorly motile, thick-walled small intestine (arrows) in the left ventral abdomen is imaged in a yearling colt with acute severe colic. The walls of the small intestine measured greater than the normal 3 mm. Serosanguinous peritoneal fluid was observed on abdominocentesis. Multiple segments of thickwalled, red and purple small intestine associated with a mesenteric defect were found at surgery. This sonogram was obtained from the left abdomen with a curvilinear probe operating at 3.5 MHz at a depth of 15 cm.

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Small intestinal volvulus in a foal. Multiple, fluid-distended, non-motile segments of small intestine are imaged in this small intestinal volvulus. This foal presented with acute, severe colic and abdominal distension. This sonogram was obtained from the ventral abdomen with a microconvex probe operating at 6.6 MHz at a depth of 13 cm.

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Small intestinal volvulus in a yearling. Multiple, fluid-distended, non-motile segments of small intestine are visualized in a yearling presenting for severe abdominal pain of several hours’ duration. Eight feet (2.4 m) of nonviable small intestine were resected at surgery. This image was obtained from the ventral abdomen with a curvilinear probe operating at 3.5 MHz at a depth of 15 cm.

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Normal small intestine. Normal small intestine (arrowhead) is located just medial to the spleen in the caudal left abdomen. It has a nondescript appearance. Wall thickness should not exceed 3 mm. This sonogram was obtained from the caudal left abdomen with a curvilinear probe operating at 6.6 MHz at a depth of 15 cm.

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Duodenal stricture. This image demonstrates duodenal thickening and stricture producing clinical signs consistent with gastric outflow obstruction in a 6-month-old Hanovarian filly. Duodenal stricture is more common in foals than in adult horses and may be secondary to ulceration of the duodenum and pyloric region. Ulceration can be multifactorial in cause, but may be associated with previous rotavirus infection. This sonogram was obtained from the right fourteenth ICS with a curvilinear probe operating at 6.6 MHz at a depth of 12 cm.

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Duodenal distension associated with postoperative ileus. The duodenum is imaged between the liver and right dorsal colon (RDC) secondary to postoperative ileus. A small pocket of hypoechoic, free peritoneal fluid is seen adjacent to the duodenum. This sonogram was obtained from the right fourteenth ICS with a curvilinear probe operating at 5.0 MHz at a depth of 15 cm.

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Duodenitis. This image demonstrates thickwalled duodenum (arrow) with echogenic luminal material in a 3-year-old Quarterhorse mare that presented with colic and gastric reflux. Salmonella spp. was isolated from the gastric fluid suggesting it may have been an etiology for the duodenitis. Normal duodenal wall thickness in an adult horse is ≤3 mm. This sonogram was obtained from the right twelfth ICS with a curvilinear probe operating at 5.0 MHz at a depth of 8 cm.

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Normal duodenum, twelfth and fourteenth ICS. (A,B) These images show normal duodenum. The cranial aspect of the duodenum is visible between the left liver lobe and the right dorsal colon. The echogenic material is luminal content within the duodenum. These sonograms were obtained from the right (A) twelfth and (B) fourteenth ICS using a curvilinear probe operating at 6.6 MHz at a depth of 18 cm.

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Normal duodenum, twelfth and fourteenth ICS. (A,B) These images show normal duodenum. The cranial aspect of the duodenum is visible between the left liver lobe and the right dorsal colon. The echogenic material is luminal content within the duodenum. These sonograms were obtained from the right (A) twelfth and (B) fourteenth ICS using a curvilinear probe operating at 6.6 MHz at a depth of 18 cm.

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Gastric distention with fluid in a neonatal foal. The stomach is markedly distended with a width greater than that of the spleen. Milk clots (arrowhead) are visible within the gastric lumen. This sonogram was obtained from the left twelfth ICS using a curvilinear probe operating at 3.5 MHz at a depth of 6 cm.

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Gastric distention. Fluid content is visualized in the stomach. The cranial aspect of the stomach is obscured by the caudodorsal tip of the lung. This sonogram was obtained from the left fourteenth ICS using a curvilinear probe operating a depth of 20 cm. Image is oriented with dorsal to the left side.

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Gastric distention. This image demonstrates a fluid-filled, distended stomach (short arrow) in an adult horse. Solid material ventrally (arrowhead) creates an acoustic shadow. A gas–fluid interface (long arrow) is present dorsally. This sonogram was obtained from the left fourteenth ICS with a curvilinear probe operating at 3.5 MHz at a depth of 23 cm.

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Spleen–stomach relationship. This image demonstrates the normal appearance of the stomach adjacent to the spleen. The normal, feed-containing stomach should appear as an echogenic curved line (arrow) against the medial surface of the spleen. The splenic portal vein (arrowhead) is seen along the medial aspect of the spleen. This sonogram was obtained from the left tenth ICS with a curvilinear probe operating at 3.5 MHz at a depth of 18 cm.

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Gastric fold. This image shows the normal appearance of stomach adjacent to the spleen in a horse fasted for gastroscopy. A gastric fold (arrowhead) is visible on the surface of the stomach. This sonogram was obtained from the left eleventh ICS using a curvilinear probe operating at 3.5 MHz at a depth of 18 cm.

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Normal esophagus. The normal esophagus is demonstrated by the arrowheads. The trachea is in the bottom left corner of the image. The jugular vein is noted by the large arrow and the carotid artery by the small arrow. This sonogram was obtained from the jugular groove, middle third of the neck, using a linear probe operating at 12 MHz at a depth of 5 cm.

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Normal duodenum, sixteenth ICS. This image shows normal duodenum ventral to the right kidney and ventromedial to the right dorsal colon. This sonogram was obtained from the right sixteenth ICS with a curvilinear probe operating at 6.6 MHz at a depth of 15 cm.