ULTRASONOGRAPHIC DIAGNOSIS—PYLOROGASTRIC INTUSSUSCEPTION IN A DOG

A 7-year-old female Maltese presented for evaluation of severe vomiting. A diagnosis of pylorogastric intussusception was made during ultrasonographic examination. The intussusception spontaneously underwent reduction by the following morning.     

Gastroduodenal intussusception in a young dog

A 21-month-old German shepherd crossbreed presented with a nine-month history of intermittent vomiting, anorexia and melaena interspersed with periods of clinical normality. Investigations suggested recurrent pancreatitis and the vomiting resolved with supportive therapy but recurred two weeks later. Abdominal radiographs revealed evidence of an intermittent abdominal mass which, on uitrasonography, had the typical appearance of an intussusception. At laparotomy, a gastroduodenal intussusception was found obstructing the pancreatic and bile duct outflows with perforation of the duodenal wail. The dog was euthanased. Postmortem examination and histology showed no obvious cause for the intussusception but confirmed pancreatic involvement. This is believed to be the first case of gastroduodenal intussusception reported in an animal.     

Caeco-caecal and caeco-colic intussusception in two half-sibling Standardbred horses

This report describes caecal intussusception in two young half-sibling Standardbred horses. Both horses presented showing signs of low-grade abdominal pain. The horses remained haemodynamically stable despite signs of abdominal pain and associated tachycardia. Exploratory celiotomy was undertaken in both horses due to persistent abdominal pain and a poor response to administration of analgesic medications. Exploration of the abdomen revealed caeco-caecal intussusception in one horse and caeco-colic intussusception in the other horse. An underlying cause for caecal dysfunction and subsequent intussusception was not identified in either patient. Manual reduction of the intussusception was successful in both cases. The horses recovered uneventfully from surgery.     

Ultrasonographic and computed tomographic features of a true gastro-gastric intussusception with concurrent foreign bodies in a dog

A 2-year-old intact male Cane Corso dog was presented for acute weakness, vomiting, and diarrhea. Abdominal ultrasound revealed the stomach had severe wall edema and a target appearance. Computed tomography was consistent with a gastro-gastric intussusception and concurrent mineral-like gastric foreign bodies. After reduction of the intussusception, bilateral incisional gastropexy was performed to prevent recurrence. True gastrogastric intussusception is a rare condition and should be considered if the stomach has severe wall edema with a target sign on abdominal ultrasound. Computed tomography was useful to confirm this rare diagnosis and screen the entire abdomen for concurrent lesions.Key clinical message:This case highlights the usefulness of a CT examination to confirm this rare diagnosis, to determine the position of gastric compartments, and to detect potential concurrent lesions prior to surgery.     

Ileal intussusception in 16 young thoroughbreds.

The paper describes the outcome of 16 cases of short-ileal-ileal intussusception in young Thoroughbred horses. The intussusception was often associated with chronic or intermittent low grade abdominal pain. At laparotomy, only the intussusception was reduced in one horse; in another, a myotomy of the thickened stenosed intussusception was carried out after reduction. In 11 cases as ileocaecal bypass anastomosis was performed proximal to the intussusception after its reduction. One horse was subjected to euthanasia during operation because of irreversible intestinal wall damage and another because of intestinal rupture. One foal had a cardiac arrest following reduction of the intussusception. One horse was subjected to euthanasia 4 months post-operatively because of intractable abdominal pain caused by intestinal adhesions. Although several horses suffered episodes of post-operative abdominal pain, and 2 were subjected to a second laparotomy, 12 horses made an eventual complete recovery.     

GASTROGASTRIC INTUSSUSCEPTION IN A DOG

A three-year-old, intact male, Rottweiler is presented with a gastrogastric intussusception. This is one of only two known reports of gastrogastric intussusception in the dog. Lateral and ventrodorsal radiographs and ultrasound revealed a gastric mass, however the diagnosis of gastrogastric intussusception was made during surgery. The patient in this report had no associated tumor and the pyloric antrum was the intussusceptum. Cause of the intussusception is unknown.     

Ultrasonographic findings of pylorogastric intussusceptions in two dogs

A Yorkshire terrier (case 1) and a Miniature Schnauzer (case 2) were diagnosed with pylorogastric intussusceptions (PGIs). Both cases showed acute vomiting and had previous histories of laparotomy. In case 1, the invaginated pyloric wall was thickened unevenly containing multiple hypoechoic areas and had indistinct wall layering on ultrasonography. PGI with diffuse gastric edema and necrosis was confirmed on laparotomy. The dog recovered completely after gastrectomy and a Y-U plasty. Case 2 had uniformly thickened walls of invaginated gastric pylorus with the distinct wall layering. PGI was reduced spontaneously the next day.     

Concurrent gastro-oesophageal intussusception, trichobezoar and hiatal hernia in a cat

CASE HISTORY: An adult male Birman cat was evaluated for recurrent, intermittent vomiting or regurgitation, occasionally associated with abdominal discomfort. CLINICAL FINDINGS AND DIAGNOSIS: Radiographs, including an oesophogram, indicated an oesophageal obstruction. Prior to treatment, the cat's condition deteriorated and it was euthanised at the owner's request. Post-mortem examination revealed a gastro-oesophageal intussusception, a trichobezoar impacted into the intussusceptum, and a dilated oesophageal hiatus consistent with a chronic hiatal hernia. CLINICAL RELEVANCE: Gastro-oesophageal intussusception is a rare condition in cats. Its aetiology in relation to a pre-existing hiatal hernia and a trichobezoar is discussed.     

Intermittent gastroesophageal intussusception in a cat with idiopathic megaesophagus

An adult female domestic shorthair cat was evaluated for chronic upper respiratory disease and vomiting. A diagnosis of idiopathic megaesophagus with intermittent gastroesophageal intussusception (GEI) was made based on radiographic and endoscopic examinations. The GEI was manually reduced by use of a stomach tube during the endoscopic procedure. An incisional gastropexy was performed to prevent recurrence. Gastroesophageal intussusception is a rare condition in cats. In dogs it is usually associated with rapid progression of clinical signs, culminating in death. In this cat, the condition was associated with chronic signs, probably due to the intermittent nature of the GEI.     

Idiopathic megaoesophagus and intermittent gastro-oesophageal intussusception in a cat

An eight-month-old domestic shorthair cat was presented with chronic vomiting for three months, with an acute increase in frequency during the past two days. A diagnosis of megaoesophagus was made by chest radiography. Diagnostic work-up for megaoesophagus was performed. A gastro-oesophageal intussusception was identified during endoscopy. Medical and nutritional therapy was instituted with a good response to the treatment.     

Ultrasonographic features of intestinal intussusception in 10 dogs

Records of dogs that had abdominal ultrasonography and surgical or pathological diagnosis of intestinal intussusception between February 1992 and June 1997 were reviewed retrospectively. Ultrasound images were reviewed with respect to appearance of the intussusception, suspected location, evidence of predisposing cause and concurrent lesions. Ten intussusceptions were found, affecting a variety of breeds. The mean (range) age of affected dogs was 2·5 (0·3 to seven) years (four females and six males) and the reported duration of clinical signs, 48 (one to 150) days. Intussusceptions were jejunojejunal (five dogs), ileocolic (three), caecocolic (one) and colocolic (one). A concentric ring sign was identified ultrasonographically in each dog and anatomical location predicted correctly in five instances. Additional ultrasonographic findings associated with intussusceptions included intestinal neoplasm in two dogs, enlarged abdominal lymph nodes in two, multiple mesenteric cysts in one and intestinal foreign body in a further dog. Thus, ultrasonography enables accurate diagnosis of intestinal intussusception and is a useful method for searching for concurrent or predisposing lesions.     

Gastroesophageal intussusception in a Labrador retriever.

A 14-month-old, intact male Labrador retriever was referred for evaluation of vomiting and regurgitation. A diagnosis of gastroesophageal intussusception with aspiration pneumonia was made. The patient responded favorably to aggressive surgical and medical management. The guarded to poor prognosis for gastroesophageal intussusception makes the successful outcome of this case unique.     

Concurrent gastro-oesophageal intussusception,trichobezoar and hiatal hernia in a cat

CASE HISTORY: An adult male Birman cat was evaluated for recurrent, intermittent vomiting or regurgitation, occasionally associated with abdominal discomfort.

CLINICAL FINDINGS AND DIAGNOSIS: Radiographs, including an oesophogram, indicated an oesophageal obstruction. Prior to treatment, the cat's condition deteriorated and it was euthanised at the owner's request. Post-mortem examination revealed a gastro-oesophageal intussusception, a trichobezoar impacted into the intussusceptum, and a dilated oesophageal hiatus consistent with a chronic hiatal hernia.

CLINICAL RELEVANCE: Gastro-oesophageal intussusception is a rare condition in cats. Its aetiology in relation to a pre-existing hiatal hernia and a trichobezoar is discussed.     

Jejunojejunal intussusception associated with a transmural adenocarcinoma in an aged cow

After 3 days of intestinal obstruction, a proximal jejunojejunal intussusception was resected during surgery in an adult Holstein cow. A transmural adenocarcinoma was found at the proximal margin of the intussusception. The cow recovered well from surgery and produced milk and embryos to expectation. During the seventh month after surgery, the cow developed pneumonia and, therefore, was euthanatized. Disseminated abdominal and thoracic neoplasia was observed at necropsy.     

Caecal intussusception in the horse: Ultrasonographic findings and survival to hospital discharge of 60 cases (2009–2013)

Diagnosis of caecal intussusception can be challenging. Transabdominal ultrasound is often used as a diagnostic tool in equine colic. Differentiation between caecocaecal and caecocolic intussusception might be useful in the decision process before surgery. The aims of this study were: 1) to assess the usefulness of ultrasound for diagnosis of intussusception and differentiation between caecocaecal and caecocolic intussusception; and 2) to determine survival to hospital discharge after surgery. Therefore, a retrospective case series (2009–2013) was performed of all colic cases with caecal intussusception (n = 60) confirmed at surgery or necropsy. In all horses, the intussusception could be visualised using ultrasound at admission. Caecocolic intussusception (n = 46) was much more common than caecocaecal (n = 14) intussusception and correct ultrasonographic differentiation between both types could be made in 92% of the cases. Ten horses (out of 14) diagnosed with caecocaecal intussusception underwent surgery, of which 8/10 (80%) were discharged, one horse (10%) was subjected to euthanasia during and one (10%) after surgery. Of the 28 (out of 46) operated horses with caecocolic intussusception, 17 (61%) survived to discharge, while 7 (25%) and 4 (14%) were subjected to euthanasia during and after surgery, respectively. Of all horses that underwent surgery, in 13/38 (34%) surgical reduction was possible, while 13/38 (34%) needed partial typhlectomy and 4/38 (11%) needed colostomy because of an irreducible intussusception. Survival to discharge after successful surgery was 12/13 (92%) when only reduction was performed, 11/13 (85%) if partial typhlectomy was needed and 2/4 (50%) after colostomy and partial typhlectomy. In conclusion, abdominal ultrasound is a useful tool in the diagnosis and differentiation of caecal intussusception. Survival to hospital discharge after successful surgery is good.     

Small colon intussusception in a broodmare

A 9-year-old pregnant Standardbred broodmare was evaluated for signs of mild abdominal pain, failure to defecate, and mild abdominal distention. Rectal examination revealed the leading edge of a small colon intussusception, and peritoneal fluid analysis indicated suppurative peritonitis. Surgical management, including reduction of the intussusception and small colon resection with end-to-end anastomosis, resulted in successful outcome (1-year follow-up evaluation). Postoperative complications including dehiscence of the ventral midline surgical incision and simple obstruction at the anastomosis site necessitated a second surgical procedure. Small colon intussusception is an uncommon cause of signs of abdominal pain and is similar to type-IV rectal prolapse.     

A case of a colocolic intussusception in a horse

The purpose of this report is to describe the clinical course and pathological findings in a horse admitted to the emergency service of the University of Georgia Large Animal Teaching Hospital for evaluation of colic, fever and diarrhoea of several days' duration. A presumptive historical diagnosis of colitis was made initially, but, due to the lack of faecal output during the first 12 h of hospitalisation and subsequent examination findings, an impaction of the ascending colon was suspected. Initial therapy consisted of rehydration with oral fluids and management of the abdominal pain with analgesic therapy. The horse did not respond to medical therapy and because of signs of persistent abdominal pain and financial constraints, the owner elected euthanasia after several days of supportive care. At necropsy, the horse was diagnosed with a colocolic intussusception.     

Ileocecal intussusception in horses: 26 cases (1981-1988)

The case records of 26 horses with ileocecal intussusception over a 7-year period were reviewed to determine clinical features of the disease and response to treatment. The median age of horses with ileocecal intussusception was 1 year and ranged from 2 weeks to 19 years. There was no apparent gender or breed predisposition to this disease. An acute form of ileocecal intussusception was diagnosed in 19 horses with signs of moderate to severe abdominal pain of less than or equal to 24 hours' duration, and a chronic form was diagnosed in 7 horses with signs of intermittent, mild to moderate abdominal pain of more than 3 days' duration. Horses with chronic ileocecal intussusception had a history of weight loss or failure to gain weight, slow growth, poor appetite, low-grade pyrexia, and postprandial signs of abdominal pain. At surgery, the involved segments of intestine (intussusceptum and intussuscipiens) in chronic cases were 2 to 10 cm long, and the ileum and much of the distal portion of the jejunum were flaccid, dilated, and thick walled. In the acute cases, the length of involved intestine ranged from 6 to 457 cm. Whereas only 1 of 7 chronic intussusceptions (14%) could be reduced, 9 of 19 (47%) acute intussusceptions were reducible. Surgical treatment included resection and jejunocecostomy (6 horses), partial resection through a cecotomy and a side-to-side jejunocecostomy (2 horses), and a side-to-side ileocecostomy or jejunocecostomy without resection (12 horses, 7 of which had chronic intussusception). Six horses with acute intussusception were euthanatized before or during surgery.(ABSTRACT TRUNCATED AT 250 WORDS)     

Ultrasonographic findings of intestinal intussusception in seven cats

The medical records of seven cats with intestinal intussusception that were diagnosed by abdominal ultrasonography and exploratory laparotomy were reviewed. In transverse ultrasonographic sections the intussusception appeared as a target-like mass consisting of one, two or more hyperechoic and hypoechoic concentric rings surrounding a C-shaped, circular or non-specific shaped hyperechoic centre. Part of the intestine representing the inner intussusceptum, located close to the hyperechoic centre and surrounded by concentric rings, was also detected. In longitudinal sections the intussusception appeared as multiple hyperechoic and hypoechoic parallel lines in four cases and as an ovoid mass in three cases. In one case the ovoid mass had a ‘kidney’ configuration. Additional ultrasonographic findings associated with intestinal intussusception included an intestinal neoplasm in one cat. The results of the present study demonstrate that the ultrasonographic findings of intestinal intussusception in cats bear some similarities to those described in dogs and humans, are relatively consistent, and facilitate a specific diagnosis.