This week’s case is a 3-month-old Maltese puppy with difficulty defecating. Post your interpretations in the comments section!
FindingsOrthogonal projections of the abdomen are available for review. There is a large amount of formed fecal material within the descending and transverse colon. There is abnormal pocketing of fecal material present caudal to the pelvic inlet in the region of the rectum. The rectum protrudes caudal to the pelvis, but there is no apparent wall thickening or abnormal deviation. The remainder of the abdomen appears within normal limits for the age of the patient.
Differential DiagnosisObstipation – congenital anatomic abnormalities, neuromuscular causes
DiagnosisBilateral congenital perineal hernias.
A straightforward perineal hernia was observed on the left side, and was repaired routinely. On the right side, there was no obvious hernia, but there was evidence of abnormal musculoskeletal development (only a small remnant of the coccygeal muscle was identified, and there was no sacrotuberous ligament present). This necessitated reflection of the right superficial gluteal muscle into the right perineal area for reconstruction of the perineal musculature.