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Gastric Mass

Sonopath Forum

Sonopath Forum

Gastric Mass

I tried to attach this cine to the last post by Pankatz but it would not let me upload a cine.

Saw this cat last week. Each day is a new learning experience.

 

 

I tried to attach this cine to the last post by Pankatz but it would not let me upload a cine.

Saw this cat last week. Each day is a new learning experience.

 

 

Comments

EL
January 9, 2015 at 2:31 am -

Cool video Randy but I’m not

Cool video Randy but I’m not seeing a gastric mass but severe fluid dilation in the gastric lumen… The pylorus maintains curvilinear patterns in the wall but maybe is spasmed down. This happens in systemic disease or obstruction if the duodenum is dilated. Its a form of ileus either mechanical or metabolic. You can see the anechoic fluid separated from the mucosal wall and the echogenic material moves a bit. If you put power diopler on it you will only get splash artifact and not true vascular flow.

There could be a mass further into the pyloric outflow but I don’t see one here.

EL
January 9, 2015 at 2:31 am -

Cool video Randy but I’m not

Cool video Randy but I’m not seeing a gastric mass but severe fluid dilation in the gastric lumen… The pylorus maintains curvilinear patterns in the wall but maybe is spasmed down. This happens in systemic disease or obstruction if the duodenum is dilated. Its a form of ileus either mechanical or metabolic. You can see the anechoic fluid separated from the mucosal wall and the echogenic material moves a bit. If you put power diopler on it you will only get splash artifact and not true vascular flow.

There could be a mass further into the pyloric outflow but I don’t see one here.

randyhermandvm
January 9, 2015 at 12:16 pm -

Thanks EL.
I will have to

Thanks EL.

I will have to take another look to see what I missed.

randyhermandvm
January 9, 2015 at 12:16 pm -

Thanks EL.
I will have to

Thanks EL.

I will have to take another look to see what I missed.

randyhermandvm
January 9, 2015 at 12:27 pm -

Here are a couple of still

Here are a couple of still images. I really have egg on my face now.

randyhermandvm
January 9, 2015 at 12:27 pm -

Here are a couple of still

Here are a couple of still images. I really have egg on my face now.

EL
January 9, 2015 at 12:53 pm -

There’s the mass randy it

There’s the mass randy it just wasnt showing in your video!! no worries re egg on face any time none of us have escaped the eggs…. often swimming in scrambled at times… in the clinical sonography curve. Been there done that but you are not wrong here at all just the video wasnt showing the mass embedded in the pylorus.

I doctored up your still here the longer arrows show the limits of the hypoechoic mass that has no curvivilinear detail to it… complete disrupted architecture meeting neoplastic criteria. Compare that to the remaining curvilinear patterns in the rest of the gastric wall. The mass region will lack peristalsis too whcih is also neoplastic criteria. The small arrow shows regional ill defined inflamed fat owing to the expansive effect of the mass. Pyloric carcinoma likely or sarcoma can get to it with a scope or go right intercostal into the hypoechoic portion of the mass with fna if you can push the body wall down to the mass avoiding the portal vein if you are comnfortable wiht it. If no mets then a Billorth resection would be in order.

If by chance the patient is euthanized though you can do a post mortem us guided bx or fna of that technique to confirm the histopath. Tons to learn from this and gives you needle practice. We can’t always cure them but we can always learn from them. Post mortem USG sampling usually goes well with owners they dont mind the thought of a needle. They just dont like the idea of a full post mortem opening up Fido. Non invasive post mortem sampling is usually an easy discussion.

Great post for all to learn from

EL
January 9, 2015 at 12:53 pm -

There’s the mass randy it

There’s the mass randy it just wasnt showing in your video!! no worries re egg on face any time none of us have escaped the eggs…. often swimming in scrambled at times… in the clinical sonography curve. Been there done that but you are not wrong here at all just the video wasnt showing the mass embedded in the pylorus.

I doctored up your still here the longer arrows show the limits of the hypoechoic mass that has no curvivilinear detail to it… complete disrupted architecture meeting neoplastic criteria. Compare that to the remaining curvilinear patterns in the rest of the gastric wall. The mass region will lack peristalsis too whcih is also neoplastic criteria. The small arrow shows regional ill defined inflamed fat owing to the expansive effect of the mass. Pyloric carcinoma likely or sarcoma can get to it with a scope or go right intercostal into the hypoechoic portion of the mass with fna if you can push the body wall down to the mass avoiding the portal vein if you are comnfortable wiht it. If no mets then a Billorth resection would be in order.

If by chance the patient is euthanized though you can do a post mortem us guided bx or fna of that technique to confirm the histopath. Tons to learn from this and gives you needle practice. We can’t always cure them but we can always learn from them. Post mortem USG sampling usually goes well with owners they dont mind the thought of a needle. They just dont like the idea of a full post mortem opening up Fido. Non invasive post mortem sampling is usually an easy discussion.

Great post for all to learn from

randyhermandvm
January 9, 2015 at 1:19 pm -

I feel a bit better now (for

I feel a bit better now (for myself- not the cat).

Owner hasn’t the funds to pursue treatment.

I will update when and if I can do a necropsy or biopsy post mortem

 

Thanks

randyhermandvm
January 9, 2015 at 1:19 pm -

I feel a bit better now (for

I feel a bit better now (for myself- not the cat).

Owner hasn’t the funds to pursue treatment.

I will update when and if I can do a necropsy or biopsy post mortem

 

Thanks

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