Case Study

04_00414 Cody W Intestinal mass with obstruction

A NM Labrador with a history of foreign body ingestion was presented for intermittent diarrhea that had initially responded to bland diet, metronidazole and aminopentamide. More recently there had vomiting and he appeared uncomfortable. On physical examination, a palpable mass in the cranial abdomen was present. CBC was within normal limits and serum biochemistry showed elevated phosphate low BUN.

Sonographic Differential Diagnosis

Intestinal mass with obstruction. This may not be neoplastic, but primary differentials include intestinal lymphoma, carcinoma, granulomatous disease or complicated inflammatory bowel disease.
Slight regional lymphadenopathy.
Possible concurrent foreign matter.
Immediate surgery with resection and anastomosis and appropriate biopsies recommended. Upon palpable thickening, the surgeon should resect an additional 5 inches of intestine as a progressive and infiltrative pattern is noted. Regional lymph node biopsy also warranted.

Image Interpretation

Stomach and small intestine revealed an obstructive pattern with echogenic chyme. Video 1 demonstrated an obstructive foreign body with thickened intestine with some loss of detail consistent with possible intussusception, but concurrent underlying intestinal mass measured approximately 5 cm with surrounding reactive fat creating obstructive pattern. Foreign matter may also be present with the mass. The mass does appear resectable. Regional lymph nodes were also slightly enlarged in video 2.