Sept. 2017 “Acute abdominal pain doesn’t always add up to foreign body!” – Sonopath’s Case of the Month – Intramural abscess

September 5, 2017
Animal Sounds NW
Being a very sweet and rambunctious young dog with acute abdominal pain doesn’t always add up to a foreign body. Sometimes it can be a sign of something more ominous and sometimes it’s not what you thought at all.

A positive Murphy Sign during the ultrasound with suspicion of possible foreign body vs. mass vs. other were the clinical differentials for this Case Of the Month.

Many thanks to Dr. Edie Demaria of Pets Aloud Veterinary Services and her wonderful team in managing this case. SonoPath Mobile’s Kelly Vazquez, C.V.T., SDEP Certified Clinical Sonographer provided the diagnostic images for this case study.

Patient Information:

Age:         3-year old
Gender:    Male, Neutered
Species:   Canine
Breed:      Labrador Retriever Mix


Above: Radiograph showing area of concern

Presenting Clinical Signs:

  • History of possible dietary indiscretion while on a hike with his owner 48 hrs prior
  • Intermittently vomiting for 24 hrs
  • Upon physical examination, the patient exhibited pain in the caudal abdomen and an abnormal structure could be felt on palpation
  • Radiographs showed an irregular, semi-circular area in the caudal abdomen
  • The patient was hospitalized on I.V. fluids and supportive care pending ultrasound

Imaging/Sampling:

  • Radiographs
  • Abdominal Ultrasound


Above: Murphy Sign – Patient exhibited signs of pain during the ultrasound in area of concern

Ultrasound Interpretation:

  • A portion of bowel appeared to be thickened and possibly intussuscepted measuring 4.0 cm with variable mural thickening that measured approximately 1.0 cm.
    • The entire structure measured approximately 4-5 cm with shadowing material.
    • The structure is likely fluid absorbing or passage of fluid is occurring as there is not a large, obstructive fluid pattern prior to the pathology.
    • Intestinal mass or intussusception is suspected with embedded luminal material.

 

Click here to view videos, pictures, and outcomes of this case: https://sonopath.com/resources/cases-month/intramural-abscess-3-year-old-mn-canine-mixed-breed-our-case-month-september-2#node-20416