Case Study

CT – Gastrc ulceration with emptying disorder and reactive lymphadenitis in a 9 year old MN Labrador Retriever

This 9 year old MN Labrador Retriever presented for recurrent vomiting which is progresseively getting worse, and poor appetite with weight loss (20 pounds in the last 2 months). Inconsistent diarrhea. Endoscopy showed significant GI ulceration, suspect pancreatic tmor or MCT.

DX

The current CT is consistent with history of gastric ulcers, emptying disorder and focal thickening due to edema of the gastric wall with secondary reactive lymphadenitis.

Image Interpretation

CT of the abdomen –

The pancreatic parenchyma presents within normal limits in the plain, arterial and venous-phase, no pathological contrast enhancing nodule or mass is seen. The stomach is moderately distended with fluid. The stomach presents regional wall thickening of up to 1 cm with bilayered appearance and reduced contrast enhancement in the region of the gastric body and pyloric antrum. The affected area measures approximately 4 x 4 cm and is semi-circumferential. The pylorus is patent with expected wall thickness and normal distribution of contrast enhancement. The duodenum is moderately filled with fluid.

Outcome

The suspected emptying disorder of the stomach can be due
to reduced motility caused by gastric ulcers.
The odds of neoplastic infiltration of the gastric wall – such as ulcerated
adenocarcinoma, round-cell neoplasia, other – are considered low based on the
imaging findings. However, definitive diagnosis would warrant full thickness biopsies. Consider palliative therapy with pain-management and empirical gastric protection
medication as the best treatment option. The pancreas presents macromorphologically sound