Case Study

Intestinal Carcinoma with Foreign Body Perforation in a 12 year old FS German Shepherd mix dog

This 12-year-old FS German shepherd mix dog presented for anorexia, occasional vomiting over a 2-week period, and mild weight loss. A CBC and blood chemistry profile revealed mild neutrophilia and a mild ALT and SAP elevations.

This 12-year-old FS German shepherd mix dog presented for anorexia, occasional vomiting over a 2-week period, and mild weight loss. A CBC and blood chemistry profile revealed mild neutrophilia and a mild ALT and SAP elevations.

DX

Intestinal carcinoma with foreign body perforation

Sonographic Differential Diagnosis

The differential diagnoses included annular jejunal wall mass consistent with neoplasia, most notably adenocarcinoma, or chronic mechanical ileus, secondary to intestinal foreign body obstruction, with accompanying inflammatory peritoneal effusion.

Image Interpretation

This image demonstrates a markedly fluid distended segment of small bowel (arrow). The hairpin turn is similar to that seen on radiographs with mechanical ileus. A segment of bowel is mildly distended with echogenic, shadowing foreign material (thin arrow). Note how the affected bowel wall is also hypoechoic, homogeneous, and lacks wall layering. This appearance is not uncommon with chronic foreign body obstruction. A small amount of anechoic free fluid is also present within the near field (wide arrow). This image demonstrates focal, marked jejunal wall thickening. The annular thickening of the jejunum completely lacks wall layering and possesses an essentially uniform, hypoechoic, and homogeneous echotexture (wide arrow). The serosal layer is smooth and uninterrupted, supporting a well-encapsulated lesion (short arrows). Empty small intestine with a prominent muscularis layer is seen adjacent to this lesion (thin arrow).

Outcome

This patient expired at the end of the surgical procedure.

Clinical Differential Diagnosis

GI pathology -Neoplasia, gastroenteritis, foreign body, hepatopathy; pancreatic pathology – pancreatitis

Sampling

An exploratory laparotomy was done and the mass was biopsied. The diagnosis was intestinal carcinoma, and luminal foreign body, localized perforation, and peritonitis.