Abnormal small intestinal segment

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Abnormal small intestinal segment

    • 10 yr old FS Lab Ret belonging to a SA veterinarian
    • Intermittent vomiting beginning 2 months ago, progressing to 2-3 times/day for the past month.
    • Bloodwork showed ALB=2.2.  ACTH stim is wnl.
    • After medical managemet with Cerenia, metronidazole, and i/d, ALB is now 2.8.  Clinical signs resume when medical management is discontinued.
    • Abdomimal ultrasound shows a thickened segment of small intestine in the right lateral abdomen running cranial to caudal with a thickened wall, thickened muscularis layer, and adjacent echogenic fat. Suspect this is the descending duodenum but unable to trace to pylorus. Stomach is mildly distended with ingesta (patient received food with meds in the am).
    • My initial thoughts are focal IBD or neoplasia.  Just wondering if any of you think this could be some sort of long-standing foreign body.  Food must be getting past this due to the chronicity and lack of distended bowel orad to the affected segment. I don’t think the owner is going to pursue surgery :(.

Comments

EL

Segmental muscularis

Segmental muscularis thickening and also reactive mesentery so the bowel has transmural pathology. The submucosa is in-tact so neoplastic rosteria isnt present and i dont see a FB but it needs to be resected. Acute on chronic inflam bowel, intestsinal necrosis, bowel infarction and emerging neoplasia all can do this. I would do intraop us and resect it if nothing else similar in the Gi tract or elsewhere.

Electrocute

Thanks Eric.  Nice to “see”

Thanks Eric.  Nice to “see” you on the IVUSS conference platform.

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