Case Study

Pyloric Stenosis with Ulcerative Gastritis in a 13 year old FS Pekinese dog

This 13-year-old FS Pekinese was presented for a long term history of intermittent vomiting with a recent episode of acute vomiting which was primarily postprandial. Medical therapy was unremarkable. Blood and urine analysis were also unremarkable.

This 13-year-old FS Pekinese was presented for a long term history of intermittent vomiting with a recent episode of acute vomiting which was primarily postprandial. Medical therapy was unremarkable. Blood and urine analysis were also unremarkable.

DX

Pyloric stenosis with ulcerative gastritis

Sonographic Differential Diagnosis

Primary consideration is given to chronic inflammatory gastropathy with resultant pyloric hypertrophy. Emerging neoplasia is considered less likely.

Image Interpretation

On the long axis views, moderate to marked, circumferential, symmetrical gastric wall thickening is present throughout the pyloric region. The effected pyloric region is irregularly layered, represented by a moderately thickened muscularis and submucosal layer. The remaining gastric wall is also mildly thickened with suggested rugal fold prominence.

Outcome

The patient expired due to surgical complications after 3 days of hospital care.

Clinical Differential Diagnosis

GI pathology – Gastroenteritis/IBD, pancreatitis, neoplasia, dietary intolerance/allergy, Helicobacter, foreign body, bowel infarction.

Sampling

US guided biopsy revealed ulcerative gastritis with fibrocollagenous proliferation. Surgical approach revealed secondary pyloric stenosis, hypertrophic gastritis and pyloric fibrosis.