Case of the week 12.2.19
Publication Date: 2019-12-02
6 images
Findings
Opposite lateral and VD views of the abdomen have been performed.
The serosal detail is normal.
The stomach is moderately gas dilated and there are a few small (up to 0.7 cm in diameter) rounded mineral opacities within the pylorus. Within the right caudoventral abdomen, there is a small intestinal segment which contains a heterogenous soft tissue opaque structure with the impression of linear striations. There is gas dilation of the proximal duodenum and multiple segments of small intestines adjacent to this small intestinal segment, with smaller fluid/soft tissue opaque small intestinal segments in the caudal abdomen, giving the appearance of two populations of intestines. The lumen of the proximal duodenum is undulant on the VD view.
The colon contains a small amount of heterogenous soft tissue opaque material consistent with feces. The liver is mildly enlarged extending past the costal arch. The spleen, unobscured margins of the kidneys, and unobscured margins of the urinary bladder are normal.
Diagnosis
- Small intestinal foreign body (most consistent with cloth material) within the right caudoventral abdomen causing small intestinal mechanical obstruction. Exploratory laparotomy is indicated.
- The undulant appearance of the lumen of the duodenum likely represents normal Peyer’s patches.
- The appearance of the liver is likely normal for the age of the patient.
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