12 year old FS Yorkie mix with lethargy and elevated liver values. Hx of urinary issues with inactive sediment. Ultrasound findings included this gastric foreign object that was not obstructive, but may be intermittently landing in the pylorus, as well as thickened urinary bladder wall, hyperechoic gall bladder debris without shadowing or evidence of biliary obstruction.
Would love some thoughts on what everyone thinks this object might be and if you think it could cause some elevated liver values (I’m sorry, but I wasn’t given the exact values)? I am rechecking her tomorrow after a 12+ hour fast.
Comments
There is pyloric hypertrophy
There is pyloric hypertrophy and delayed outflow pattern in video 1. There is a 1 cm free floating structure in video 2 but non obstructive. may even be a pill not dissolved yet. My guess is the pyloric hypertrophy is more the issue. Some aspects of hypertrophic pyloric gastropathy here but not complete criteria.
Thank you Eric. Do you think
Thank you Eric. Do you think the hypertrophy could have been related to the foreign object going in and out?
No I think the foreign
No I think the foreign structure is incidental. There i is mural disease in that pyl antrum.
This is most likley emerging
This is most likley emerging pyloric hypertrophy as there are no GI signs as yet. As Eric mentions the “foreign body” is incidental. Pyloric hyertrophy can be associated with chronic ulceration, Helicobacter, helminths, and hypergastinemia from reduced clearance (liver or renal dysfunction) or gastrinomas (Zollinger-Ellison syndrome) that can orginate in the pancreas and duodenum.
Consider enodoscopy of the upper GI tract.
Thank you so much for the
Thank you so much for the additional ideas!