医学交流课件：PART 5 LIVER, GALLBLADDER and SPLEEN.pptVIP

PART 5 LIVER, GALLBLADDER and SPLEEN Dr Ulrike Kafka (BVSc) (Hons) (DI) LIVER INDICATIONS liver enzymes Clinical symptoms Secondary liver disease Follow-up of recurrent hepatic disorders LIVER LANDMARKS Clip hair along costal arch Deep-chested dogs One to two intercostal spaces Dorsal, left or right lateral recumbency Subcostal approach usually sufficient for all liver lobes LIVER PITFALLS Deep-chested dogs Microhepatica Spleen displaced cranially Obese patients Falciform fat Overlying subcutaneous fat Over-full stomach Gas-filled colon LIVER ULTRASONOGRAPHIC ANATOMY Four lobes Left, right, quadrate, caudate Four sublobes Right, left lateral and medial Two processes Caudate, papillary Triad of vessels at hilus Portal vein CVC Aorta LIVER ULTRASONOGRAPHIC ANATOMY LIVER PATHOLOGY Diffuse changes in echogenicity Hyperechoic Steroid hepatopathy Fibrosis Lymphoma Lipidosis Liver Hyperechoic Video 1614 LIVER PATHOLOGY Diffuse changes in echogenicity Hypoechoic Passive congestion Acute hepatopathies Lymphoma Histiocytosis Amyloidosis Cholangiohepatitis LIVER PATHOLOGY Diffuse changes in echogenicity Mixed echogenicity Benign hyperplasia Carcinoma Metastases Necrosis Amyloidosis Lymphoma LIVER PATHOLOGY Changes in hepatic volume Hepatomegaly (HM) Steroid hepatopathy Lipidosis Acute hepatopathies Passive congestion Infiltrative neoplasia Diffuse metastases Amyloidosis LIVER PATHOLOGY Changes in hepatic volume (Microhepatica) Congenital porto – systemic shunt (PSS) Microvascular dysplasia (MVD) Primary portal vein hypoplasia Cirrhosis Fibrosis Severe hypovolaemia LIVER PATHOLOGY Focal hepatic lesions Anechoic Cyst Cystic tumour Necrosis Abscess Haematoma Focal haemorrhage (after biopsies) LIVER PATHOLOGY Focal hepatic lesions Hypoechoic Nodular hyperplasia Primary neoplasia Metastases Lymphoma Abscess Haematoma Complex cyst Necrosis Liver Neoplasia Video 1525 LIVER PATHOLOGY Focal hepatic lesions Hyperechoic No