This week’s case is a 15 year old domestic shorthair referred for chronic obstipation and weight loss.
There is dilated bowel occupying the majority of the abdomen, giving it a distended appearance. The dilated loops are filled with fluid and mineral opacity material. The loops could be colon; however, they seem more extensive than the normal amount of large intestine. There is a small amount of gas in the terminal colon and rectum, which is not filled with fecal material.
A barium enema confirmed that the dilated bowel was not colon.
There was limited visibility in the abdomen. The dilated segment of bowel tapered into a narrowed area (arrow) with some loss of wall layering and hypoechoic echogenicity. At surgery, the adenocarcinoma appeared as a fibrotic strictured area.
- Chronic partial small intestinal obstruction
Stricture due to adenocarcinoma of the ileum.
A barium enema was performed (see additional images), which confirmed that the dilated bowel was not large intestine in origin. The mineral material in the small intestine oral to the obstruction is characteristic of a “gravel sign”, or accumulation of particulate matter that is too large to pass through the intestinal lumen at the site of obstruction.
Ultrasound was performed; however, visibility was limited due to the large amount of attenuating material in the colon.