Presentation
Acute vomiting and diarrhea for three days after eating part of a plastic trash can.
Patient Data
There is a cranioventrally distributed patchy alveolar pattern in the right cranial and right middle lung lobes. The right side of the heart is poorly visualized on the dorsoventral projection.
There is radiopaque foreign material suspended in the pylorus on the left lateral projection, surrounded by gas.
The foreign material seen on the thoracic radiographs remains fixed in the pylorus on the abdominal projections. This is most visible on the left lateral and ventrodorsal projections. The small intestine has a plicated appearance on the right lateral projection, and some bowel loops are dilated and contain mineral opacity material. This is consistent with a linear foreign body.
At a three month recheck examination, the alveolar pulmonary pattern has resolved. The thorax remains slightly hypoinflated with a bronchial pattern.
Case Discussion
Aspiration pneumonia is a common consequence of vomiting or regurgitation. The pattern of distribution is cranioventral, and it may be unilateral or bilateral. The pneumonia resolved after antibiotic therapy. The remaining bronchial pattern may be inflammatory airway disease. Bulldogs also have a small thorax and wide mediastinum which causes increased opacity.
The cause for the pneumonia in this case was a foreign body lodged in the stomach and extending into the small intestine. A left lateral projection positions gas in the pyloric region, highlighting the foreign material which is unable to fall to the fundus with gravity while lodged. The linear foreign body was confirmed with abdominal ultrasound and removed via gastrotomy and enterotomy. The foreign material was rope, grass, wood, and other material.
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