ULTRASONOGRAPHIC DIAGNOSIS-PYLOROGASTRIC INTUSSUSCEPTION IN A DOG

Pylorogastric intussusception in a puppy with a congenital intrahepatic portosystemic shunt – a case report

A sixteen-week-old female Akita-inu puppy was presented for investigation of acute vomiting, diarrhoea, and abdominal distension. Abdominal ultrasound revealed a single congenital right-sided intrahepatic portosystemic shunt and pylorogastric intussusception, which spontaneously resolved during the next three days after initial examination. Owners elected for euthanasia due to the clinical deterioration of the patient that reflected in development of clinical signs associated with liver insufficiency, guarded prognosis and financial concerns for transjugular coil embolisation.

Duodenogastric intussusception with concurrent gastric foreign body in a dog: a case report and literature review

A 3 yr old spayed female boxer weighing 22.8 kg was presented for severe, acute vomiting and tenesmus. Tachycardia, tachypnea, dehydration, and abdominal pain were present on physical examination. Abdominal radiographs showed a foreign object (golf ball) in the fundus of the stomach, and a larger, round, soft-tissue opacity mass in the region of the pylorus. Endoscopic removal of the foreign object was unsuccessful. A large soft-tissue mass (duodenogastric intussusception) was visualized with endoscopy, but was not correctly diagnosed until surgery. A midline exploratory celiotomy was performed and the duodenogastric intussusception was diagnosed and manually reduced. Severe pyloric wall edema and minimal bruising were present. A routine fundic gastrotomy was performed and the foreign object was removed. A right-sided incisional gastropexy and duodenopexy were performed in attempt to prevent recurrence of the intussusception. The dog was discharged from the hospital 38 hrs after surgery, and was normal on follow-up 1 yr after surgery. The dog in this report is the sixth documented case of duodenogastric/pylorogastric intussusception in the veterinary literature. This is the first reported case with a concurrent gastric foreign body and endoscopic visualization of the intussusception.

Ultrasonographic findings of pylorogastric intussusceptions in two dogs

A Yorkshire terrier (case 1) and a Miniature Schnauzer (case 2) were diagnosed with pylorogastric intussusceptions (PGIs). Both cases showed acute vomiting and had previous histories of laparotomy. In case 1, the invaginated pyloric wall was thickened unevenly containing multiple hypoechoic areas and had indistinct wall layering on ultrasonography. PGI with diffuse gastric edema and necrosis was confirmed on laparotomy. The dog recovered completely after gastrectomy and a Y-U plasty. Case 2 had uniformly thickened walls of invaginated gastric pylorus with the distinct wall layering. PGI was reduced spontaneously the next day.

Endoscopic diagnosis of a pylorogastric intussusception with spontaneous resolution

A 7 mo old intact female golden retriever was evaluated for acute vomiting. Abdominal radiographs revealed a possible gastric foreign body. Upper gastrointestinal endoscopy revealed an edematous, tubular antral mass, which on further evaluation was determined to be a pylorogastric intussusception based on radiographic, endoscopic, and surgical findings. Spontaneous resolution of the intussusception occurred upon surgical exploration of the abdomen. Histopathology of a full-thickness gastric biopsy revealed vascular congestion consistent with an intussusception, but did not indicate the primary cause. The dog recovered uneventfully from surgery and had no further vomiting during the 6 mo follow-up period. This case was significant as it was the first report of pylorogastric intussusception diagnosed using endoscopy. This description of the unique endoscopic appearance of pylorogastric intussusception will be useful for the veterinary endoscopist.

Pylorogastric intussusception in a Chihuahua puppy. A case report

A three-month-old Chihuahua dog was presented with acute abdominal pain, vomiting and cardiovascular shock. Abdominal ultrasound (US) and iodated contrast gastrogram revealed suspected pylorogastric intussusception. Because of the poor prognosis the dog was euthanatized. Diagnosis of pylorogastric intussusception was confirmed at necropsy. Parasitological, virological, serological and histological examinations were also performed. This report documents the sixth case of pylorogastric (i.e. duodenogastric, gastrogastric) intussusception in the veterinary medical literature and it is the first report on a puppy dog in which US and radiographic diagnosis were confirmed post mortem.