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Pyloric duodenal mass

Sonopath Forum

Sonopath Forum

Pyloric duodenal mass

Sadie being evaluated for liver enzyme elevation.

Has a sludgy gall bladder heading towards a mucocele.

Incidentally found this mass at the pyloric duodenal junction. Didn’t see any bile duct dilation and seems to high up for a mass at the duodenal papilla, doesn’t have any elevation in bilirubin.

Wondering about sampling. Pet is not clinical for GI signs. Not a clear window for FNA. Would have to cross the stomach wall to get to it. Talked about endoscopy or exploratory or just follow up to assess for any changing size etc.

Sadie being evaluated for liver enzyme elevation.

Has a sludgy gall bladder heading towards a mucocele.

Incidentally found this mass at the pyloric duodenal junction. Didn’t see any bile duct dilation and seems to high up for a mass at the duodenal papilla, doesn’t have any elevation in bilirubin.

Wondering about sampling. Pet is not clinical for GI signs. Not a clear window for FNA. Would have to cross the stomach wall to get to it. Talked about endoscopy or exploratory or just follow up to assess for any changing size etc.

Thoughts?

Comments

EL
March 14, 2019 at 4:53 am -

Round cell neoplasia mural

Round cell neoplasia mural lesion… carinoma less likely. You may get there with SDEP 11 or 13 or 14 laying the patient on the left side for sdep 13 or 14. Push the body wall down or have a tech do it so you get the lesion close to the needle under sedation of course. Should get there with a 22 x 1.5 in but spinal needle may help too. Looks like its in the caudal aspect of the pylorus too high for cbd and you can follow the mural structure of the stomach around the mass so its GI for sure. Would need a bIllroth for resection which is an option if no mets.

bhylands77
March 14, 2019 at 6:13 pm -

Wondering about a leiomyoma.

Wondering about a leiomyoma.

rlobetti
March 15, 2019 at 4:05 pm -

Possiblity of this being a

Possiblity of this being a mural abscess/granuloma?

Bottom line needs an aspirate.

 

animage
March 18, 2019 at 5:57 pm -

Thank you great thoughts!

Thank you great thoughts!

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