This week we have a young adult terrier cross that presents for evaluation of emaciation, inability to gain weight, and panhypoproteinemia. This is not your run of the mill case! Post your comments below.
There is severe loss of serosal detail due to the thin body condition of the patient. Multiple loops of small bowel are severely gas distended and appear to have a plicated pattern. The stomach is full of granular appearing ingesta, which is also seen extending down the duodenum on the v/d projection. An angular mineral opacity is present in the caudal small bowel. There is a convex soft tissue density seen intruding into an enlarged loop of small bowel in the dorsal abdomen on the left lateral projection.
Distended bowel loops with a convex soft tissue appearance could indicate intussusception. The foreign material in the stomach and duodenum, gravel sign, and plication suggest a linear foreign body and chronic partial obstruction. Decreased dorsal detail is likely in part due to poor body condition although the presence of peritoneal effusion is likely.
Chronic linear foreign body with multiple intussusceptions
Multiple intussusceptions containing hard-shadowing foreign material were seen on ultrasound exam. On radiographs, the intussuscepting bowel is often outlined by gas in the distal portion of the bowel loop, appearing as a blunt-ended, soft tissue opacity.
Because of poor prognosis, euthanasia was elected. The gastrointestinal tract is plicated and enlarged (white arrows) with several intussusceptions (black arrows). The plication pattern is difficult to discern because of the marked distension of the bowel loops.