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mesenteric rent

Sonopath Forum

Scanned a 7 yr MI Melinois cross last week.  He had a history of mesenteric torsion repaired 6 months ago with significant small bowel resection at that time.  Had started vomiting last week intermittent.  Lab work showed an elevated ALT (800), otherwise unremarkable.  Ultrasound showed increased portal markings in the liver and the stomach had mild thickening of the muscularis layer in the ventral wall; dorsal wall difficult to full visualize due to panting/gas, but lumen was not signficantly distended.  Next day, rads were very profound with gastric dilation and m

Scanned a 7 yr MI Melinois cross last week.  He had a history of mesenteric torsion repaired 6 months ago with significant small bowel resection at that time.  Had started vomiting last week intermittent.  Lab work showed an elevated ALT (800), otherwise unremarkable.  Ultrasound showed increased portal markings in the liver and the stomach had mild thickening of the muscularis layer in the ventral wall; dorsal wall difficult to full visualize due to panting/gas, but lumen was not signficantly distended.  Next day, rads were very profound with gastric dilation and multiple loops small bowel very distended with gas and fluid.  Went to surgery and found a rent in the mesentery, presumedly from the first surgery (I do not have the surgery report yet).  My question is, is there anything suggestive of this problem on U/S before it progresses to entrapment? I am assuming fuzzy, hyperechoic mesentery, but looking for any other guidance……

Comments

EL

I would think ill defined and

I would think ill defined and remodeled mesentery would have been present but tough to say. The GI pattern and positioning may have been altered. The intestine takes smooth turns in general but in adhesions and entrapment an obstructive pattern forms and sharp directional intestinal changes occur typically in my experience.