Case of the week 12.3.18

Adrien-Maxence Hespel

University of Tennessee

veterinary.radiology.mirc@gmail.com

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Publication Date: 2018-12-03

History

4 month old male Pointer. Vomiting, diarrhea 1 day duration

Quiz

1. There is evidence of mechanical obstruction

   a	Yes :-)
   b	No :-(

1. There is evidence of free abdominal air

   a	Yes :-(
   b	No :-)

Findings

Orthogonal radiographs of the abdomen are available for interpretation.

There is marked decreased serosal detail, mostly due to visceral crowding and patient's young age.

The stomach is markedly distended and contains a large volume of fluid with gas caps. There are multiple markedly distended loops of small intestines. A loop of small intestines within the caudal abdomen contains heterogenous soft tissue material with a striated pattern. There are some less distended segments of intestine which contain lobular heterogenous soft tissue material, some of which may represent colon.

There are multiple gas foci throughout the abdomen, superimposed with the distended intestines.

The liver is largely obscured, however, on the right lateral view, the size is normal.

The osseous structures are normal for the patient’s reported age. The included thoracic structures are normal.

Diagnosis

The changes are consistent with a pyloric outlow obstruction and small intestinal mechanical obstruction, the SI obstruction being due to cloth material foreign body.

There is no definitive evidence of pneumoperitoneum

Conclusion

Part of the surgical report: " Cloth foreign material was palpated within the stomach. A mid-jejunal cloth foreign body was also present; intestines orad to the obstruction were moderately gas distended. "

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