Gastrointestinal Ultrasound Karen Gormley

Indications Vomiting +/- blood Diarrhea +/- blood Anorexia Alternative to contrast studies Abnormality on radiograph Neoplasia suspected FNA

Structures Esophagus Stomach Small Intestine Ileocecocolic junction Colon

Esophagus Usually done with endoscopy

Esophageal abnormalities Strictures Masses

Stomach – normal Best if no air Empty = “wagon wheel” Dogs 3-5 mm Cats ~2 mm Layers Mucosal surface (hyper) Mucosa (hypo) Submucosa (hyper) Muscularis propria (hypo) Subserosa/serosa (hyper)

Stomach abnormalities Foreign body Ulcers Neoplasia Inflammation Mineralization

Small Intestine - normal Wall thickness 2-4 mm dog 2-3.2 mm cat Wall layering Lumen (hyper) Mucosa (hypo) * Submucosa (hyper) Muscularis (hypo) Serosa (hyper) Motility 4-5 contractions/min duodenum 1-2 contractions/min distal Can’t see both walls if gas present

Small intestine - sections Duodenum – location Jejunum, ileum Ileocecocolic junction Mucosa projects into lumen

Small intestine abnormalities Wall thickness Wall layer pattern Motility Obstruction Foreign body Neoplasia Plication Intussception Metastatic calfication Pneumatosis intestinalis/coli

Colon - normal Limited by air & feces Asses wall thickness & symmetry

Colon abnormalities Abnormal wall thickness Mural & extramural masses Intussusception