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9 year old MN Great Dane, febrile, lethargic. Does this look like a duodenal ulcer? I did not appreciate much surrounding inflammation. CBC unremarkable. albumin 1.9, globulins 5.8. Some GI stasis and poor motility on rest of ultrasound, but otherwise unremarkable.
I have not encountered duodenal ulcers before – any specific treatment recommendations different from gastric ulcers?
Comments
It looks like there is
It looks like there is somewhat of a small crater in the wall with some gas artifact but I dont appreciate any gas within the wall itself. It looks like wall layering is maintained. So could be a small superficial ulcer there and I would cover with similar gastric ulcer protocol. Also could be more diffuse disease with the albumin levels and GI stasis so sonographic monitoring would be ideal with potential for biopsies if continued signs. Consider plasma expanders and braod spectrum Abs with the fever if not already instituted.
Thank you for the feedback.
Thank you for the feedback. I need to search ulcers to get a better understanding of what I am looking for. How do I distinguish gas in the wall from artifact?
note the indentation of the
note the indentation of the hyperechoic gas into the mucosa. Helps to zoom in. Deeper ulcers penetrate the submucosal layer and muscularis while perforating ulcers disrupt the serosa as well…. its a follow the curvilinear pattern disruption essentially.
Thank you for clarifying!
Thank you for clarifying!
Consider baseline cortisol
Consider baseline cortisol for Addiosons disease with the ulcer as well as decreased albumin and GI signs if GI signs continue or are recurrent.
Good point – I don’t think
Good point – I don’t think this has been done yet. Thank you.