Case Of the Month

Intestinal Obstruction

A 1-year-old MN DSH cat was presented for evaluation of vomiting for a duration of 3 days. The patient has a known history of frequently eating innapropriate things around the house (strings, foreign objects, etc…). The owner reported no urination or bowel movement for 2 days. No vomiting, coughing, sneezing, or diarrhea was noted. The physical examination was unremarkable. CBC and blood chemistry found an very elevated HCT of 52.7%, eosinopenia, thrombocytopenia, mild hyperglycemia, elevated BUN, elevated calcium, low albumin, and slightly elevated ALT.

DX

Foriegn body obstruction; a pistachio.

Outcome

The patient underwent an abdominal exploratory in which a pistachio was removed from the jejunum via uncomplicated enterotomy. The patient recovered uneventfully.

Sonographic Differential Diagnosis

Upper gastrointestinal obstructive pattern. Suspect foreign body.

Image Interpretation

The stomach was dilated in this patient with anechoic fluid. The fluid dilation continued into the pylorus. Gas artifact was noted in the upper gastrointestinal and stomach. This obscured some visibility. The small intestine was dilated and was followed by empty small intestine. The midabdomen revealed echogenic material in what appeared to be the small intestine. The descending colon presented some stool.