Known Case Conference – Abdominal Radiographs

18 Jul

Patient data:  10-years-old, neutered male, DSH cat

History: anorexia, vomiting, lethargy

Technique:  abdominal radiographs

There is diffuse increased peritoneal contrast with presence of multiple gas bubbles not associated with the gastrointestinal tract. The peritoneal fat is increased in opacity with hazy appearance, in particular at the level of the falciform ligament. There is mild to moderate homogeneous gastrointestinal distention with gas.

Pneumoperitoneum and peritonitis/steatitis/effusion. Concomitant diffuse functional ileus of the gastrointestinal tract.

Differentials include:

  1. Spontaneous rupture of gastrointestinal neoplasia
  2. Perforating gastrointestinal foreign body

Consider:

  1. Direct exploratory laparotomy or
  2. Abdominal ultrasound if the owner refuses farther treatment in case of abdominal neoplasia

 

ABDOMINAL ULTRASOUND:

Abdominal ultrasound shows severe asymmetrical thickening of the gastric wall with loss of layering and intramural gas. There is a linear hyperechoic defect in the gastric wall with communication between the gastric lumen and the peritoneal space. Changes are most consistent with gastrointestinal neoplasia (ex. round cell tumor) with secondary malignant ulcer and perforation.

FNA of the gastric wall confirmed lymphoma.

 

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