- 5 yr old FS Pitbull with history of acute vomiting and anorexia.
- Chem prof shows mildly elevated ALT, AST, increased Amylase and lipase, abnormal cPLI
- Radiographs show a linear radio-opaque densitiy in the small intestine
- Abdominal ultrasound shows normal intestines with no FB and normal pancreas
- The stomach wall is thickened and contains ingesta, however, the patient presumably did not eat today.
- 5 yr old FS Pitbull with history of acute vomiting and anorexia.
- Chem prof shows mildly elevated ALT, AST, increased Amylase and lipase, abnormal cPLI
- Radiographs show a linear radio-opaque densitiy in the small intestine
- Abdominal ultrasound shows normal intestines with no FB and normal pancreas
- The stomach wall is thickened and contains ingesta, however, the patient presumably did not eat today.
- At first I thought I saw a possible circular FB in the stomach, however, it looks more like some sort of invagination of the stomach wall, pylorus, or perhaps a very pronounced rugal fold, and less likely polyp. What do you all think?
Comments
To me that looks rather
To me that looks rather suspicious. The round silhouette appears too round and distinct for being part of the wall and the hypoechoic linear shadow dorsal to it also appears suspicious for some luminal foreign content. Whenever there are suspicious contents in stomach my approach is usually re-scanning. A few hours later if it is possible (I can usually do that as I’m not on a mobile service), alternatively 24hs or 48hs later or if I advice scoping I usually try and scan before the procedure, too, in case things have disappeared and owner can save some money. I’m not sure that is thickened wall…it looks like some foreign material. But let’s see what EL has to say.
Thick gastric wall almost
Thick gastric wall almost meeting criteria for HPG . Its this an acute on chronic thing? What does the GES look like? Can you find the GES on this dog because this looks like a gastroesophageal intussusception or partial but that would not be th ecase if you can see a normal GES further dorsally. When in doubt go back to clinical signs … if not responding to a helicobacter type protocol and slurry feeding and rescan in a few days then its surgical anyway even if to just get BX of that wall.
This dog is having recurrent
This dog is having recurrent episodes of “pancreatitis” (cPLI positive, anorexia, and vomiting). I did not see the gastroesophageal junction, although this is a deep chested dog and it is not something I routinely identify. How common is a gastroesophageal intussusception? I did have the impression of a telescoping effect. And lastly, what does HPG stand for? Hypertrophic pyloric gastritis? Helicobacter? Thanks!
-M
Hypoertrophic pyloric
Hypoertrophic pyloric gastropathy = hpg
More on Imaging the GES see the thread I just posted here:
https://sonopath.com/forum/gi-sweep-pylorus-ges
Thx!
Thx!
Well, kudos to you GCSM! It
Well, kudos to you GCSM! It was a pacifier that was removed a few days later after it moved on into the duodenum.
Those damned passifiers way
Those damned passifiers way cool thanks for the follow-up!
You’re welcome. Still
You’re welcome. Still appreciate all of the differentials as I was not familiar with gastroesophogeal intussusception.
Oh!!! Now that shape makes
Oh!!! Now that shape makes sense! These pets are amazing at what they eat! I just found a sewing needle at a cat’s ICCj…not a single scratch! With thread and All!
Thank you for update!!!
I agree, the best part of the posts and comments are the differentials! I have so many bookmarked!