Case Study

Ileocecocolic Junction Foreign Body in a 6 month old MI mixed breed dog

This 6-month-old MI mixed breed dog presented for acute vomiting and poor appetite but otherwise normal. The physical exam was relatively unremarkable except for excessive gastrointestinal activity, borborygmus and moderate hyperthermia.

This 6-month-old MI mixed breed dog presented for acute vomiting and poor appetite but otherwise normal. The physical exam was relatively unremarkable except for excessive gastrointestinal activity, borborygmus and moderate hyperthermia.

Sonographic Differential Diagnosis

Suspect mucosal sloughing and regional lymphadenopathy consistent with inflammatory disease. The lymph node characteristics support reactive lymphadenopathy (Video 3.) Adhered intraluminal material suggests the presence of blood clots. Primary consideration is given to gastritis secondary to dietary indiscretion with reactive lymphadenitis

Image Interpretation

The stomach is mildly to moderately distended with fluid, gas and echogenic ingesta. Discrete, irregularly shaped, hypoechoic, homogeneous structures are also noted within the gastric lumen and may be adhered to the gastric wall, given their persistence in location. The stomach wall is diffusely, moderately thick walled and abnormally layered, represented by a prominent muscularis. Regional thinning of the mucosal layer and is also noted. A mildly to moderately enlarged, normally shaped, and mildly hypoechoic regional lymph node is also present Video 3.Diffuse, moderate gastric wall thickening with stasis. A distal small intestinal stasis pattern was also noted followed by a progressively shadowing luminal structure and empty small intestine (Videos 1 & 2.)

DX

Ileocecocolic junction foreign body

Outcome

The patient thrived postoperatively with IV support, intravenous antibiotics and GI protectant therapy.

Clinical Differential Diagnosis

GI pathology – Dietary indiscretion, GI foreign body, parasitic disease/other infectious, intussusception; pancreatic pathology – pancreatitis; toxicosis.

Sampling

Exploratory laparotomy was performed that revealed an accumulation of sticks, pine needles, hair, and string at the ileocecal junction. Blood clots were present in the stomach. Full thickness gastrointestinal biopsies revealed mild, diffuse, chronic, lymphocytic bacterial gastritis consistent with helicobacter infection. Intestinal biopsies at the ileum revealed moderate lymphoplasmacytic enteritis with Peyer’s Patch hyperplasia. Mesenteric lymph node biopsies revealed moderate eosinophilic lymphadenitis and lymphoid hyperplasia.