Strong shadowing gastric contents

Hope 10 yr FS, Chihuahua mix, 15.14 pounds

presented with chronic history of intermittent vomiting and weight loss, recently last two months has been having copraphagia. Has a distended abdomen on physical exam, radiographs indicated significant  distension of stomach with soft tissue opacity and amorphous granular material in the fundic region. ALT elevated 129, ALP elevated 520, GGT elevated 32, platelets mildly increased 426, urine specific gravity 1.004.

When the patient is in dorsal recumbency the stomach protrudes and feels pretty firm but on scanning the stomach contents are creating a strong shadow. The pyloric duodenal junction appears to have altered wall layering but I feel like there is hyperechoic linear structure within the lumen that causing some plication. Tracing the duodenum distally however the duodenum appears normal without the plication and remainder of the small intestines do not show any signs of foreign body.

Gallbladder is filled with inspissated sludge looking like a mucocele is forming in the liver is mildly enlarged and hyperechoic and there’s bilateral adrenomegaly suspecting this dog may have Cushing’s disease.

I feel like this dog needs to go to surgery for a gastrotomy. I have not heard of any gastric tumors that would create that strong shadow however. Would appreciate additional opinions.

Thank you!

One response to “Strong shadowing gastric contents”

  1. Sorry for the delay. Unless

    Sorry for the delay. Unless the small intestine has accordian pleating then this is likely passive luminal material. That being said the mucosa is thick and remodeled and warrants biopsy. Aspects of hypertrophic pyloric gastropathy are there but not all the criteria. Could scope as well. This echogenic linear material enters into the pylorus so if its fabric it will typically continue into the duodenum and anchor. But a grass ball or similar fits this here best i think because there is an empty non obstructive pattern and the luminal direction is not changed.

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