Gastric ulcer surgical or medical

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Gastric ulcer surgical or medical

One-year-old female Chihuahua. She was presented for dystocia yesterday. The RDVM did ovariohysterectomy – the puppy was dead. Today, presented in emergency following hematemesis, followed by sudden collapse. I found a blood clot and gastric ulcer on ultrasound, looks deep and very close to serosa. Following stabilisation, do you think we should excise it surgically?

Comments

Eric Lindquist

Nice image, seems to be still mucosal as the submucosa, muscularis, and serosa arent involved yet so I would tx medically and scan every 3-4 days til resolved unless getting worse then resect of course. Ensure no NSAIDS are in use

Inam ul - Haq

Thank you Erric. This was a bit confusing one. In some views, it looked perforated and in some not. I considered it as a perforating one because of a lot of hyperechoic fat in that region and due to the draining tract I saw. Image attached. I took the screenshot from the attached video. What do u think? Hope it is not just my mind playing with me:)

Eric Lindquist

I didnt get that resolution off your image but that’s a great shot. With that info I would cut. Post a sx photo if you can

Inam ul - Haq

Unfortunately, this patient was too sick and while she was being stabilised, she vomited once again and then expired. Hardly 1.2kg, and the blood loss was very acute. One more thing, mucosa of this patient is mainly hyperechoic with a bright hyperechoic line on the luminal side. What could be the reason for that. Inflamation?

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