Case Of the Month

Perforated Intestine From A Linear Foreign Body In A 14-Year-Old MN Dachshund: Our Case Of the Month 2017

A 14-year-old, MN, Dachshund was presented for vomiting, fever, diarrhea, and anorexia x 3 days. The patient had a history of pancreatitis and foreign body. The patient had a painful abdomen. Blood work revealed leukocytosis, neutrophilia, low albumin (2.1) and cPL WNL. Radiographs were suspect for peritoneal effusion/peritonitis; irregular gas pattern – enteritis or pancreatitis.

DX

Perforated intestine with linear foreign body and peritonitis.

Outcome

Immediate exploratory surgery for this patient was recommended, with expectations toward abdominal lavage. This is likely a meat skewer or similar. Resection of the portion of perforated GI tract will likely be necessary. Expression of the gallbladder is also recommended. Abdominal lavage and minimizing adhesions will be necessary in this patient. Aggressive antibiotic therapy and pain management is indicated. Biopsies of the underlying gastrointestinal tract were recommended to assess for underlying disease.

Image Interpretation

The caudal abdomen revealed a hard shadowing linear foreign body, consistent with a meat skewer or similar material. The foreign body measured 3.82 cm. Foreign body appears to have perforated the distal duodenum or jejunum. Immediate exploratory surgery is recommended. A portion of the jejunum revealed loss of detail with focal reactive mesentery noted. This is likely the portion of intestine that is affected. Echogenic free fluid was noted in the abdomen. Free air was also noted.