A 3-year-old NM Border cross with a history of eating socks was presented emaciated, 7% dehydrated, and painful on palpation. Abnormalities on CBC and serum biochemistry were neutrophilia, mild hyperglycemia, and low sodium, chloride, and potassium.
A 3-year-old NM Border cross with a history of eating socks was presented emaciated, 7% dehydrated, and painful on palpation. Abnormalities on CBC and serum biochemistry were neutrophilia, mild hyperglycemia, and low sodium, chloride, and potassium.
Gastrojejunal foreign body with free fluid and emerging peritonitis. Potential underlying inflammatory bowel presentation. Secondary intussusception owing to tethering and accordion pleating of the intestinal foreign body. Recommend immediate exploratory surgery with expectations towards gastrotomy. Full thickness gastrointestinal biopsies are recommended at the site of incision to assess for chronic disease in the small intestine and stomach. Multiple abdominal lavages will likely be necessary.
The gastrointestinal tract revealed progressively shadowing foreign matter within the pylorus. The pyloric foreign body is likely fabric and continued into the upper small intestine. Accordion pleating and secondary intussusception formation was noted in the distal jejunum along with a 4+ cm shadowing region of foreign matter with minor free fluid. Regional inflammation was noted. This is suggestive for emerging peritonitis. Variable areas of small intestine revealed hypertrophied muscularis and increased submucosal echogenicity. This is likely indicative of underlying inflammatory bowel disease that may be inducing PICA in this patient. The jejunal lymph nodes were enlarged at 0.66 x 2.0 cm.
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Intestinal foreign body, focal intestinal perforation with peritonitis, IBD, dietary hypersensitivity, intestinal lymphoma
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