Why left lateral abdominal radiographs are important

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Free for Elite Members

May 2016

In today’s VETgirl online veterinary CE video, we demonstrate the importance of performing a left lateral abdominal view. Commonly in veterinary practice, a ventral-dorsal (VD) and right lateral radiograph is performed. While it takes extra time and manipulation to perform a left lateral radiograph, it can often be diagnostic as it helps identify inappropriate gas or fluid distribution within the stomach.

In this VETgirl video, we review a case of a 10-year, male neutered, Labradoodle who presented with a 1 day history of vomiting, anorexia, lethargy, and abdominal pain. On presentation, the patient was lethargic, tachycardiac, hypotensive, and had a painful abdomen on palpation. A 30 mL/kg intravenous crystalloid bolus was given to help stabilize the patient’s hypovolemia. Diagnostic workup in this patient included baseline blood work and radiographs. Originally, a right lateral and VD radiograph was performed, which revealed a distended stomach and a dilated loop of bowel. Whenever you see a dilated stomach on radiographs in a vomiting patient, you should be concerned about ileus or an outflow obstruction. (Ideally, a venous blood gas could also have been performed in this case to look for the presence of a metabolic alkalosis, which is commonly seen with pyloric outflow obstructions or even intestinal foreign bodies, but that’s another VETgirl podcast!).

So, why is a left lateral radiograph especially important in certain patients?

When the patient is positioned in left lateral recumbency, the gas within the stomach will float to the pylorus (which is on the right side of the body). This is an easy way to utilize the gas in the body to create a natural gastrogram, highlighting the pylorus. On this patient’s left lateral view, you can clearly see the foreign object, which was virtually invisible on the right lateral view. This confirmed the pyloric outflow obstruction and the patient was taken to surgery once stabilized. A gastrotomy and an enterotomy was performed to remove the outflow obstruction and linear foreign body.

When in doubt, if you don’t have fancy tools like abdominal ultrasound (or a radiologist), utilize that extra opposite-lateral radiograph to help you!

Check out our other VETgirl videos for additional tips and procedures!

This VETgirl video is sponsored by Antech. As a veterinary professional, you deserve a choice. Now, you have it with Antech. Experience North America’s largest reference laboratory network, comprehensive in-house analyzers and solutions, the most trusted diagnostic imaging equipment, advanced telemedicine and AI-powered solutions, and the flexibility to practice medicine your way. The right diagnostics, at the right time — all from Antech.

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  1. Hi, I am starting to use VetGirl for CE, but I am very confused as to how I get “credit.” For instance, I just watched this video– where will I see my times calculated to add up to hours ? Also, is there a way to get credit for watching past Webinars ? I’m confused about how to review those as well.

    In general, I am confused on how this works and can”t tell if everything (podcast or video or webinar, etc) gives you CE or not. Obviously I am happy to learn, but I also want to make sure I can quantitate my time for Continuing Ed purposes. Thanks very much– Dr Dawn Amor

  2. We now take 3 view abdominal xrays on every patient- have caught some very cool things this way!

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