Case of the week 4.17.23
Publication Date: 2023-04-16
History
11 year old male castrated Pomeranian. Straining to defecate.
5 images
Findings
Orthogonal radiographs of the abdomen are available for interpretation.
The liver extends caudal to the costal arch, but appears otherwise normal in size for the patient’s conformation. The gastric axis is normal. There is a focal convexity along the craniolateral aspect of the left kidney. The right kidney is mostly obscured by the gastrointestinal tract, but its discernible margins are normal. The urinary bladder and a distended portion of the aborad colon have herniated into the perineal region. The urinary bladder is mildly to moderately distended. The herniated portion of the descending colon is filled with heterogeneous stool. The remainder of the descending colon contains a small volume of formed stool while the orad colon and cecum are gas-filled. The stomach contains a small amount of gas. The small intestines are moderately distended with fluid. There is a rounded to lobular, mineral opaque structure with a slightly more lucent center in the plane of the descending colon in all views. Mild spondylosis deformans is noted at the lumbosacral junction. The lateral fabella of the right pelvic limb is incidentally multipartite.
Diagnosis
- Perineal hernia with herniation of the urinary bladder and a portion of the colon.
- Focal convexity of the left kidney may represent a large renal cyst or a benign or malignant renal nodule.
- Mineral opaque structure in the plane of the colon may represent incidental foreign material or nodular fat necrosis (Bates body) in the adjacent mesentery
Discussion
The patient underwent surgical correction.
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