Presentation
Presented with acute vomiting. He had a foreign body removed from his GI tract 9 months previously. Gastropexy was performed at that time. Septic peritonitis developed post operatively.
Patient Data
The pyloric portion of the stomach and the proximal duodenum are dilated with fluid and gas. The duodenum travels dorsally on both lateral projections. The duodenum narrows abruptly just ventral to L2, where a small amount of gas continues distally.
Impression:
Mechanical obstruction in the proximal small intestine.
Case Discussion
Duodenal-jejunal stricture at the site of previous resection and anastomosis.
This case is unusual because the small intestinal obstruction is a complication of previous surgery. The signs are similar to a high obstruction though, with an enlarged stomach and duodenum, and more normal sized jejunum.
It is fortunate to have gas acting as a natural contrast medium and outlining the stricture on both lateral projections. Otherwise, an upper GI examination would have been an appropriate next step. Ultrasound was also performed, but this is a difficult diagnosis to make with ultrasonography given the deep chested dog and the gas filled intestine.
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