Sonopath Forum

Second opinion on Duodenum

12 year old male neutered diabetic dog that presented for being unwell and inappetent. There is no vomiting or any gastrointestinal signs.Blood work showed leukocytosis 19.2 X 10 ⁹ /L, neutrophilia 14.0 X 10 ⁹ /L and monocytosis 1.7 X 10 ⁹ /L.

There was also increased nucleated red blood cells in the abscence of anaemia.( not sure if this is relevant to the duodenum)

I wanted to know if anyone has seen a duodenum like this? Is it significant? What could cause the hyperechoic band in the mucosal layering?

There was also increased nucleated red blood cells in the abscence of anaemia.( not sure if this is relevant to the duodenum)

I wanted to know if anyone has seen a duodenum like this? Is it significant? What could cause the hyperechoic band in the mucosal layering?

Comments

November 24, 2016 at 4:35 pm -

It looks like its all mucosal

It looks like its all mucosal and not a typical lymphangectasia pattern or mucosal fogging… but I would lean toward that. Diabetics make hyperechoic deposits everywhere… medullary rim kidney and lipogranulomas in liver and spleen for example. I’m guessing its something similar to that but worth checking periodically and likely can ignore if no upper GI signs. Cover for ulcerative duodenitis just to be sure given the anorexia since the jejunum looks fine and PLE usually involves more than just the duodenum.

lookpris

November 25, 2016 at 11:25 am -

Thanks eric! What is ‘mucosal

Thanks eric! What is ‘mucosal fogging’?

Some books were mentioning dilated lacteals in the mucosa causing the hyperehoic ‘band’ but is uncertain about the cause.

What an interesting looking intestine, haven’t seen anything like this!

November 25, 2016 at 4:49 pm -

well mucosal fogging is a

well mucosal fogging is a term I created to describe coalescing striations… some lymphangectasia cases have more fogging than striations to where you cant see the striations. See this example attached