Case of the week 11.5.18

Adrien-Maxence Hespel

University of Tennessee

veterinary.radiology.mirc@gmail.com

Publication Date: 2018-11-05

History

8 year old female spayed golden retriever. 2 days history of vomiting. Today wants to eat

Next step

1. What is the best next step?

   a	Treat the patient medically for gastroenteritis No :(
   b	Isolate the patient as you suspect Parvovirus No :(
   c	Endoscopically remove the foreign body No :(
   d	Go to surgery as you suspect a linear foreign body Yeah !

Findings

Opposite lateral and VD projections of the abdomen are available for interpretation.

The serosal margin detail is normal.

An elongated, slightly curved, mixed soft tissue and gas opaque granular structure is noted within the pylorus, best seen on the left lateral and VD views. The small intestine is markedly corrugated, with numerous segments containing interspersed, comma-shaped gas bubbles. An elongated, mixed soft tissue and gas opaque granular structure is noted within a small intestinal segment in the caudoventral abdomen, ventral to the descending colon. The colon contains a small amount of formed fecal material and gas.

The liver, spleen, kidneys and urinary bladder are normal. The stomach is mildly gas distended.

The included portion of the lungs is normal.

Diagnosis

• Linear foreign body, anchored in the pylorus, and resulting in marked small intestinal plication. Exploratory laparotomy is recommended.
• Small caudal vena cava is most consistent with dehydration/hypovolemia.

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