Case Study

Ileocecocolic Intussusception in a 6 month old M Chesapeake Bay Retriever dog

This 6-month-old M Chesapeake Bay Retriever was presented for acute and persistent vomiting over the prior 36 hours. The patient had a 1 week history of diarrhea as well. The physical exam revealed mild dehydration, tacky mucous membranes, and a tense abdomen that did not allow for deep palpation. The CBC demonstrated mild anemia while the blood chemistry analysis was normal. Urinalysis was not performed.

This 6-month-old M Chesapeake Bay Retriever was presented for acute and persistent vomiting over the prior 36 hours. The patient had a 1 week history of diarrhea as well. The physical exam revealed mild dehydration, tacky mucous membranes, and a tense abdomen that did not allow for deep palpation. The CBC demonstrated mild anemia while the blood chemistry analysis was normal. Urinalysis was not performed.

DX

Ileocecocolic intussusception

Sonographic Differential Diagnosis

Ileocecocolic intussusception.

Image Interpretation

Transverse and longitudinal images of an ileocecocolic intussusception are provided. Notice the “too many layers” appearance on the longitudinal image and “onion skin” presentation on the transverse view. The echogenic material within the intussusceptum (inner most) contains echogenic material, which likely represents retained chyme, while the echogenic material within the intussuscipiens lumen (outermost) likely represents entrapped, inflamed mesenteric fat. The length is important to evaluate because intussusceptions greater than 10 cm in length suggest the presence of compromised blood flow due to tearing of contributing blood supply; resection and anastomosis is usually required. Video 1 reveals gastric stasis and minor pyloric outflow thickening. Video 2 demonstrates the multilayered intussusception with enveloped mesenteric root lymph node which is exemplary for ileocecocolic intussusception.