Author

Stephen J. Birchard DVM, MS, Diplomate ACVS

Friday, September 27, 2013

Case Outcome: Patriot the pitbull with acute vomiting


Based on Patriot's acute onset of vomiting and diarrhea, a palpable hard abdominal mass, and the mixed density opaque object on radiographs (Fig. 1-2), exploratory laparotomy was recommended to the owner.


Fig. 1: Lateral abdominal radiograph with opaque density (arrow)
Fig. 2: Ventrodorsal radiograph with opaque density. (arrow)

A ventral midline abdominal approach was performed. All structures were normal except for the ileo-ceco-colic area of the intestine. (Fig. 3-4)
Fig. 3: Ileo-ceco-colic area of intestine. The cecum was impacted with
firm material that was obstructing the ileum. (arrow)
The firm foreign body in the cecum and was manually massaged, fragmented, and moved into the colon. (Fig. 4) No incision in the cecum was necessary.
Fig. 4: Ileo-ceco-colic area after manually moving the foreign material into the colon.
Arrow indicates the now empty cecum.

Patriot made an uneventful recovery from surgery. He began eating and defecating normally several hours after surgery and was discharged 1 day postoperatively. One week after surgery the owner reported that he was doing well with no vomiting or diarrhea.

Comments

An interesting feature of this case was the severity of the vomiting even with a low (or distal) intestinal obstruction. The position of the foreign body on radiographs (cranial right abdomen) was consistent with a ileo-ceco-colic obstruction. The lack of intestinal dilation probably indicated a partial obstruction.  Ultrasonography or pneumocolon radiography would have been helpful to definitively localize the lesion.

Please post any questions or comments you have about this case either in the Comments box below or at: https://www.facebook.com/DrStephenBirchardVeterinaryCE