Case of the week 8.8.22
Publication Date: 2022-08-07
History
8 month old male Rottweiler. Vomiting. Unable to hold food or water.
6 images
Findings
Study: Opposite lateral and VD radiographs of the abdomen are available for interpretation.
Findings: The several detail is mildly decreased in the cranial and caudal aspects of the abdomen. The stomach is severely distended with fluid, gas and striated soft tissue opaque material. Best seen on the left lateral projection, a portion of the striated soft tissue opaque material is highlighted by gas in the pyloric antrum and is seen extending dorsally toward the pylorus; the material curves caudally in the plane of the duodenum and is suspected to extend slightly caudal to the 13th ribs. Similarly on the VD projection, ill-defined striated material is seen in the plane of the proximal descending duodenum. There is a large volume of striated to stippled soft tissue and gas opaque material and numerous variably sized mineral opaque foci distended a small intestinal segment in the right caudal abdomen. Multiple additional small intestinal segments are abnormally moderately fluid and gas-distended. Several small intestinal segments of normal diameter are present in the caudal abdomen. The colon contains a small volume of gas but is largely empty.
The liver, spleen and unobscured margins of the kidneys and urinary bladder are normal. Open physes are present, consistent with the patient’s young age.
Diagnosis
- Gastric and small intestinal textile-like foreign bodies resulting in a pyloric outflow obstruction and additional small intestinal mechanical obstruction. Surgery is indicated.
- Mildly decreased serosal detail is likely due to visceral crowding; a scant volume of peritoneal effusion cannot be entirely excluded.
Discussion
A large amount of foreign material was identified in surgery within the stomach extending into the duodenum to the proximal jejunum (towel). The foreign material was linear causing bunching of the intestines and 2 easily reducible intussusceptions.
Notes
This case was initially seen by Dr. Debow
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