13 yo F/S Yorkie BSC 8/9.
Presented for bloody diarrhea. Hx of pancreatitis.
Neutropenia (2.75 < 2.79), leukopenia (5 < 5.05)
Severe cholestasis (ALP 1600). ALT 196.
Plumb adrenals (L 5.5 R 6.9)
Large hyperechoic liver.
GB: partially organized sludge, partial mucocele.
Big pancreas.
Mildly Enlarged mesenteric LN, 6.3mm
Stomach: 1.4cm hypoechoic intramural nodule projecting in the lumen. Leiomyoma vs leiomyosarcoma vs GIST vs granuloma vs Pythiosis (?).
Question: the stomach nodule is in the dorsal wall. I didn’t FNA because I would have to go through the ventral wall, the lumen and the dorsal wall. Would you FNA anyway?
Thank you!
Julie
Comments
If the stomach is empty as in
If the stomach is empty as in these videos i have not had an issue going through one wall to get to a lesion on the opposite wall. Likely will need a corkscrew fna technique. You may be ablte to access it with patient on his back and approaching it right of midling medial to the spleen. Or could just cut it out and use intraoperative ultrasoung to locate and delineate it.
Thank you so much for your
Thank you so much for your input. I was wondering if it would be safe. Now I know. Not sure if they went to surgery, I’ll ask.