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Small intestine foreign body with localized peritonitis in an 11 year old MN Golden Retriever

Case Study

Small intestine foreign body with localized peritonitis in an 11 year old MN Golden Retriever

An 11-year-old NM Golden retriever with a history of Parvo and intussusception as a puppy was presented for evaluation of vomiting for 5 days and anorexia.

An 11-year-old NM Golden retriever with a history of Parvo and intussusception as a puppy was presented for evaluation of vomiting for 5 days and anorexia.

Sonographic Differential Diagnosis

Distal small intestine foreign body with focal regional thickening. Likely concurrent disease, possibly neoplastic. Localized peritonitis.

Image Interpretation

 The remainder of the gastrointestinal tract was unremarkable. The distal small intestine revealed a 1.6 cm foreign body with concentric wall thickening with loss of mural detail and regional inflammation.  The foreign structure has a linear approach to it. An attached linear structure appeared to be present with tortuous small intestine in this region. Regional early peritonitis was noted. Part of this may be owing to prior adhesions from prior surgery. Slight amounts of free fluid were noted. This pathological presentation is just cranial to the urinary bladder.

DX

Small intestine foreign body with localized peritonitis

Outcome

Immediate exploratory surgery is recommended with aggressive resection and anastomosis of the affected small intestine. Given the loss of mural detail this could be owing to chronic inflammation. However, underlying neoplasia is a potential. There was no other evidence of neoplasia in the abdomen, yet neoplastic criteria is met within the small intestinal wall thickening. Intraoperative ultrasound with aggressive resection and anastomosis would be ideal in this case along with removal of the foreign matter. Guarded prognosis depending upon underlying histopathology. Three view chest radiographs are recommended prior to study. According to recent research by Sonopath presented at ECVIM 2016 in Stockholm and published in Advances in Small Animal Medicine and Surgery May 2017, revealed concurrent underlying chronic inflammatory neoplastic intestinal disease can often reside in PICA patients. Therefore, surgical biopsies are essential in this case.

Clinical Differential Diagnosis

GIT – foreign body, neoplasia, intussusception, granuloma, Helicobacter gastritis, ulceration, helminths
Pancreas – pancreatitis, neoplasia
Renal/liver disease

Patient Information

Patient Name : Zack Renaud
Gender : Male, Neutered
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Code : 04_00553

Clinical Signs

  • Anorexia
  • Vomiting

History

  • Intussusception
  • Parvovirus

Images

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Clinical Signs

  • Anorexia
  • Vomiting