Presentation
Presents with several days of vomiting and anorexia.
Patient Data
The liver is mildly enlarged with rounded margins. The stomach is mildly distended with fluid and gas. There is an enlarged intestinal loop, likely the duodenum, on the lateral projections. There is a rounded area of mixed gas and soft tissue opacity within the lumen. On the ventrodorsal projections, the duodenum is moderately distended with fluid and gas, with several unusual gas bubbles. There is a soft tissue-gas interface at the caudal duodenal flexure. The remainder of the small intestine is normal in diameter. A metallic sewing needle is present in the retroperitoneal space. No abnormalities are noted in the spleen or urinary tract. Radiopaque sutures are present in the ventral abdominal wall.
An ultrasound examination was performed to confirm the location of the foreign body. The duodenum was distended with fluid proximal to the clean-shadowing foreign object, and returned to normal diameter distal to it. A laparotomy was performed to remove both the foreign body and the sewing needle. The liver biopsy showed vacuolar hepatopathy.
Case Discussion
The foreign body that was removed by enterotomy was a corn cob. The kernels often trap gas in a regular, geometric pattern visible on radiographs, however this was not clear in this study. The abrupt soft tissue-gas interface was indicative of an intraluminal foreign body, and is sometimes seen in cases of intussusception. The ultrasound demonstrates nicely the abrupt change in intestinal diameter proximal and distal to the foreign object which is preventing flow of ingesta.
The hepatic biopsy showed lipogranulomas and vacuolar hepatopathy, attributed to degenerative changes.
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