Case of the week 6.12.23
Publication Date: 2023-06-12
History
6 year old standard poodle. Anorexia for 2 days. Restless 1 day. Vomited once. Diarrhea after the owner gave some laxative 4 days ago.
6 images
Findings
Abdomen - ventrodorsal and lateral radiographs are available for interpretation.
Abdominal serosal detail is normal. The stomach contains a mild volume of homogeneously soft tissue/fluid opaque material, heterogeneously soft tissue opaque material and gas. There is a mild volume of gas and heterogeneously soft tissue opaque material within the pylorus on the left lateral radiograph. There are fragmented small intestinal gas opacities within the right mid-cranial abdomen and are suspected to represent gas foci within the duodenum. On the ventrodorsal radiograph, these gas foci are similarly fragmented and stacked/coiled. The remaining small intestinal segments contain mild volumes of gas and homogeneously soft tissue/fluid opaque material and are uniform in size. The colon contains a mild volume of gas and heterogeneous fecal material.
The liver, spleen, kidneys and urinary bladder are normal. Within the included portions of the thorax, there is a mild unstructured interstitial pulmonary pattern superimposed with the caudal subsegment of the left cranial lung lobe. There is nominal periarticular new bone formation associated with the coxofemoral joints.
Diagnosis
- The heterogeneously soft tissue opaque material within the stomach in association with the fragmented gas foci in the region of the descending duodenum, is most concerning for linear foreign material resulting in plication of the duodenum that is anchored in the pylorus. - The unstructured alveolar pulmonary pattern superimposed with the caudal subsegment of the left cranial lung lobe is most concerning for aspiration pneumonia given the reported vomiting, however, atelectasis is also considered. - Nominal bilateral coxofemoral degenerative joint disease.
Discussion
The patient underwent abdominal surgery. See part of the surgery report below: " An abdominal explore was performed. A completely obstructive linear foreign body was palpated tracking from the stomach through the duodenum and into the proximal jejunum causing intestinal plication. " (Dr.Bevelock)
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