Today's Veterinary Practice

MAY-JUN 2018

Today's Veterinary Practice provides comprehensive information to keep every small animal practitioner up to date on companion animal medicine and surgery as well as practice building and management.

Issue link: https://todaysveterinarypractice.epubxp.com/i/969768

Contents of this Issue

Navigation

Page 60 of 87

59 MAY/JUNE 2018 ‚óŹ TVPJOURNAL.COM CLINICAL INSIGHTS This lobe can be evaluated using a ventral or lateral approach. When using the ventral approach, place the transducer medial to the right 13 th rib and angle dorsally and cranially to get the right kidney in long axis. Next, angle medially to find the descending duodenum. Moving the transducer medial to the descending duodenum will allow one to identify the location of the right lobe of the pancreas ( FIGURE 1 ). In the dog, the pancreaticoduodenal vein can be an anatomic landmark for the right lobe of the pancreas adjacent to the duodenum. To image the right lobe in cross section, first the duodenum is imaged in long axis, the transducer is then rotated 90 degrees to obtain a cross section of the duodenum, and the right lobe will be visible as a triangular structure immediately adjacent to the duodenum ( FIGURE 2 ). In the cat, the right lobe extends along the descending duodenum and then hooks back on itself ( FIGURE 3 ). The right lobe of the pancreas and the descending duodenum are closer to a midline position when compared to the dog. Left Lobe The left lobe extends to the left of midline, near the cranial pole of the left kidney, but rarely to the level of the splenic hilum in the dog. The left lobe is closely associated with the greater curvature of the stomach and found in a region bound cranially by the stomach, caudally by the transverse colon, and, in the near field, by the body of the spleen; it is closely associated with the splenic portal vasculature ( FIGURE 4 ). FIGURE 3. Longitudinal (sagittal) B-mode ultrasound image medial to the descending duodenum from a normal cat. The tip of the right lobe ( RP ) of the pancreas can be seen turning back in a cranial direction ( white arrow ), forming a hook. The pancreas is hypoechoic to the surrounding mesentery and measures 5 mm in its thickest area. RK , right kidney. FIGURE 2. Transverse CT image at the level of the cranial descending duodenum in a dog (the dorsal aspect of the patient is at the bottom of the image, and the right side of the patient is on the left side of the image) ( A ). The right lobe of the pancreas ( white arrow ) is seen as a triangular structure along the dorsal aspect of the descending duodenum ( DD ), and the left lobe of the pancreas ( # ) is to the right of the gastric lesser curvature. Transverse ultrasound image at the level of the right kidney ( RK ) in the same dog as Figure 1 with the descending duodenum ( DD ) in cross section and the right lobe of the pancreas representing the mildly hyperechoic triangular structure to the right (medial) of the descending duodenum ( B ). The pancreaticoduodenal vein is visible as a rounded, anechoic structure between the duodenum and pancreas. ST , stomach; CA , caudate lobe of the liver. A B

Articles in this issue

Links on this page

Archives of this issue

view archives of Today's Veterinary Practice - MAY-JUN 2018