This week we have a 3-year-old male neutered Labrador Retriever that has been vomiting pink-tinged foam for several hours. Stomach is palpably distended with gas. Unable to pass a stomach tube.
The stomach is distended with gas and fluid, however the fundus and pylorus are in their normal positions.
There are several loops of small intestine that are located cranial to the stomach. The most cranial loop, presumed to be the duodenum, is located left of midline on the v/d projection.The majority of the small intestine has been displaced dorsally and to the right.
The spleen appears caudally and ventrally displaced. There is good abdominal serosal detail. The esophagus is gas distended.
There is a focal alveolar pattern in the right middle lung lobe indicating aspiration pneumonia.
- 360 degree gastric dilation and volvulus (GDV)
- aspiration pneumonia
Typical findings in a GDV of less than 360 degrees are gastric dilation, displacement of the fundus and pylorus, and compartmentalization. When the stomach rotates a full 360 degrees the normal anatomic relationships of the stomach are maintained, and the radiographic appearance is not typical. Other features, such as megaesophagus, and the displaced duodenum, indicate that there is malposition of the stomach. Clinical findings such as inability to pass a stomach tube can help to support the diagnosis.
360 degree GDV is rare and often not diagnosed on radiographs. In a study of 220 dogs, 2.5% had a 360 degree rotation.¹
This dog’s stomach was derotated and a gastropexy was performed. There was no ischemia of the stomach or other organs.
- Fischetti AJ, Saunders HM, Drobatz KJ. Pneumatosis in canine gastric dilatation-volvulus syndrome. Veterinary Radiology & Ultrasound 2004;45:205-209.