Clinical History:
5 year old, female neutered, Miniature Bull Terrier
She presented with acute vomiting and inappetence for the last 24 hours. On examination she appeared dull and had abdominal pain. In house haematology and biochemistry revealed dehydration but were otherwise unremarkable. She had a history of foreign body ingestion and bladder stones. Abdominal and thoracic radiographs were taken.
(Scroll down for radiographs)
Left lateral abdomen
Right lateral abdomen
VD abdomen
Left lateral thorax
Right lateral thorax
Diagnostic Interpretation:
There is a mineral opacity in the right dorsal mid abdomen (blue arrows) contained within a segment of small intestine. This mineral opacity measures approximately 3.9 x 2.4 x 2.5 cm and is partially surrounded by a radiolucent gas halo. The serosal detail throughout the abdomen is adequate. The small intestines are uniform and within normal limits for size. The kidneys, liver, spleen and urinary bladder are radiographically normal. Spondylosis deformans is noted at the lumbosacral intervertebral disc space. The remaining skeletal structures associated with the abdomen are unremarkable.
The cardiac silhouette and pulmonary vasculature are within normal limits. The pulmonary parenchyma is unremarkable. There is mild attenuation of the caudal mainstem bronchi on the left lateral projection that is alleviated on the right lateral view. There is no evidence of pleural disease or intrathoracic lymphadenopathy.
Conclusions:
1. Intestinal foreign body.
2. Possible dynamic mainstem bronchial collapse.
3. Degenerative changes at the lumbosacral intervertebral disc space.
Additional comments:
A small intestinal foreign body such as a peach pit is suspected and is likely causing intermittent or partial obstruction. Surgical intervention is warranted.
Further diagnostic workup for potential mainstem bronchial collapse should be considered if the patient has or develops consistent respiratory signs.
Lumbosacral disease should be considered given the degenerative changes at the lumbosacral intervertebral disc space.
Update:
An exploratory laparotomy was performed and a piece of foam was found in the distal duodenum/ proximal jejunum. This was removed and she has since recovered well without any complications.