Intestinal obstruction due to a focal lesion in small intestine: mass or FB?

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Intestinal obstruction due to a focal lesion in small intestine: mass or FB?

  • 6 yo F/S indoor cat presented for anorexia/lethargy, normal bloodwork. No improvement with Cerenia/SQ fluids/Antibiotics.
  • Chronic URI (for years) with firm SQ swelling on frontal bone.
  • Severely dilated stomach with anechoic fluid. No Fb or mass in stomach.
  • Dilated duodenum and most jejunum with anechoic fluid: ileus vs obstruction.
  • All intestines have a prominent muscularis, but still measure WNL (2mm).
    • 6 yo F/S indoor cat presented for anorexia/lethargy, normal bloodwork. No improvement with Cerenia/SQ fluids/Antibiotics.
    • Chronic URI (for years) with firm SQ swelling on frontal bone.
    • Severely dilated stomach with anechoic fluid. No Fb or mass in stomach.
    • Dilated duodenum and most jejunum with anechoic fluid: ileus vs obstruction.
    • All intestines have a prominent muscularis, but still measure WNL (2mm).
    • Normal Ileocolic junction, normal mesenteric LN, normal GB/liver/pancreas. No free fluid.
    • VIDEO of the Lower right abdomen: one abnormal portion of intestinal loop (1cm long) is thickened with a focal loss of layers. Differentials: mass vs chronic FB (not shadowing) vs other. The intestines cranial to the lesion are dilated, and the intestines distal to the lesion are not dilated. The lesion seems to be the cause of the obstruction. 
    • Exploratory was recommended. Owner declined, patient was euthanized. Necropsy declined.
    • Question: What are your thoughts about this abnormal loop? Thank you for your input!

    Julie Pearson

Comments

EL

there is a partial

there is a partial obstructive pattern with dilated sm int followed by empty small intestine. Regional ill-defined mesentery may be an adhesion or even intestinal torsion/rotation as we see it in 2D. Focal dysfunctional bowel can cause this as well. Nothing says neoplastic criteria here though.

Sometimes you hydrate these guys really well and the pattern normalizes in cases of shock bowel.

Would have needed exploratory.

sonopaws

Erik, thank you so much for

Erik, thank you so much for your input! It could be an adhesion, I didn’t think about that. The cat had very high WBC 2 weeks ago, which resolved with Orbax (Pyelonephritis was suspected by rDVM at first). Sad case, sweet cat. Thanks again.

EL

My pleasure
 

My pleasure

 

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