Avaliação Semiológica e Diagnóstico em Pequenos Animais - Aula 15 e 15.1

Summary

In this lesson, the focus is on ultrasonography of the digestive system in small animals, with a special emphasis on gastric anatomy. The video covers the indications for performing an ultrasound, such as vomiting, diarrhea, weight loss, and abdominal pain. The structure of the stomach, including its larger and smaller curvatures, pyloric region, and mucosal folds, is examined in detail. Additionally, the layers of the stomach wall are explained, with their respective echogenicities and how they may change in the presence of disease. The lesson concludes by discussing what to observe during an ultrasound examination, including the stomach's layers, relationships with other organs, and the content of the stomach.

Takeaways

• 😀 **Indications for Ultrasonographic Exam**: Ultrasonography is recommended for animals with vomiting, diarrhea, progressive weight loss, abdominal pain, anorexia, palpable masses, and suspected inflammatory bowel disease, especially in cats.
• 😀 **Gastrointestinal Symptoms**: Vomiting, diarrhea, tenesmus (difficulty defecating), melena, and anorexia all suggest the need for an ultrasound to assess digestive health.
• 😀 **Stomach Anatomy Overview**: The stomach's key structures include the greater curvature, pyloric region (leading to the duodenum), and the esophagus/cardia junction.
• 😀 **Ultrasonographic Layers of the Stomach**: The stomach wall consists of five layers: mucosa (hyperechoic), submucosa (hypoechoic), muscularis (echogenic), serosa (hyperechoic), and a final serosa layer.
• 😀 **Ultrasound Features of Healthy Stomach**: The five layers should be clearly visible in a healthy stomach; any disruption can indicate pathology.
• 😀 **Content of Stomach Lumen**: Pay attention to whether the stomach contents are food, gas, mucus, or foreign bodies, as each type requires different diagnostic consideration.
• 😀 **Peristalsis Evaluation**: The natural movement of the stomach (peristalsis) should be assessed to ensure it is properly emptying food into the intestines.
• 😀 **Species Differences in Ultrasound**: Cats have shallower mucosal folds compared to dogs, which should be noted when interpreting ultrasound images.
• 😀 **Size Measurements**: Accurate measurement of the stomach, duodenum, and other structures is essential to identify abnormalities like enlargement or shrinkage.
• 😀 **Role of Ligaments**: The stomach's ligaments play a significant role in vascularization, which affects the echogenicity of the stomach wall and should be considered during an ultrasound.
• 😀 **Next Class Preview**: The upcoming lesson will focus on the specific diseases of the gastrointestinal system and how they appear on ultrasound images.

Q & A

What are the primary indications for performing an ultrasonographic examination of the digestive system in small animals?

The primary indications include vomiting (acute or chronic), diarrhea possibly associated with bacterial or inflammatory processes, progressive weight loss, melena, tenesmus, anorexia, abdominal pain, increased abdominal volume, palpable masses in the digestive system, and signs of inflammatory bowel disease, especially in cats.

What does the anatomy of the stomach look like in ultrasonography?

In ultrasonography, the stomach shows the greater curvature, the pyloric outlet leading to the duodenum, and the entry of the esophagus. Inside the stomach, the mucosal folds and the different layers of the gastric wall can be observed, including the mucosa, submucosa, muscular layer, and serosa.

What are the layers of the stomach wall visible on ultrasonography?

The layers visible in ultrasonography include: the mucosa (innermost layer, hyperechoic), submucosa (hypoechoic), muscular layer (hyperechoic), and serosa (outermost layer, hyperechoic). These layers help in identifying any abnormalities in the stomach wall.

How do the mucosal folds in cats compare to those in dogs in terms of ultrasonographic appearance?

In cats, the mucosal folds of the stomach are less deep and less prominent compared to those in dogs. This difference in the depth of the folds is important when evaluating gastric structures through ultrasonography.

What are the key aspects to observe when performing an ultrasonographic examination of the stomach?

Key aspects to observe include the presence of all gastric layers, the stratification of the gastric wall, the relationship between the stomach and surrounding organs, the intraluminal contents (e.g., food, gas, mucus, foreign bodies), and gastric motility, which indicates normal movement of food through the stomach into the intestines.

What should be assessed regarding the intraluminal contents during an ultrasonographic exam of the stomach?

The intraluminal contents should be evaluated to determine if they are gas, food, mucus, or a foreign body. These findings provide important diagnostic information about the stomach's condition.

What is the significance of observing the movement of the stomach (peristalsis) in ultrasonography?

Peristalsis is the natural movement of the stomach that helps push the contents into the intestines. Observing this movement helps assess the stomach’s functional ability to empty and facilitates the diagnosis of potential motility disorders or obstructions.

How are the different ecogenicities of the stomach layers interpreted in ultrasonography?

The different ecogenicities of the stomach layers allow the identification of each layer’s structure. The mucosa is hyperechoic, the submucosa is hypoechoic, the muscular layer is hyperechoic, and the serosa is hyperechoic as well. Any changes in these ecogenicities can indicate pathological conditions such as inflammation or tumors.

What should be considered when measuring the size of the stomach in ultrasonography?

When measuring the stomach, it’s essential to compare the size to normal reference ranges for the species. Abnormal enlargement or shrinkage may indicate pathology such as gastric dilation or hypomotility.

Why are cats more commonly affected by inflammatory bowel disease in the digestive system compared to other animals?

Cats are more commonly affected by inflammatory bowel disease due to their particular susceptibility to this condition. This disease leads to inflammation in the digestive tract and is often diagnosed through ultrasonographic evaluation, which helps identify changes in the stomach and intestines.