Intestinal Obstruction

Patient Information

Age

1 Year

Gender

Male, Neutered

Species

Feline

Keywords

Blood Chemistry

CBC

Images

Anechoic fluid dilation is noted in the stomach that is uniform to the level of the pylorus (arrow) without and evidence of pyloric obstruction.

A distinctly shadowing 1.5 cm structure (large arrow) is evident in the duodenum followed by empty small intestine after the obstruction (small arrow). The dilated small intestine before the shadowing foreign body was present but not in view in this image.

Kitty cats sometimes feel like a nut!! (Watch keyboard cat's video here!) A pistachio nut intestinal obstruction in this case of the month submitted by the late night emergency and critical care vets at Garden State Veterinary Services, in Iselin New Jersey, USA. Telemedicine interpretation from Monteporzio Catone (Rome), Italy by Dr. Eric Lindquist

History

A 1-year-old MN DSH cat was presented for evaluation of vomiting for a duration of 3 days. The patient has a known history of frequently eating innapropriate things around the house (strings, foreign objects, etc…). The owner reported no urination or bowel movement for 2 days. No vomiting, coughing, sneezing, or diarrhea was noted. The physical examination was unremarkable. CBC and blood chemistry found an very elevated HCT of 52.7%, eosinopenia, thrombocytopenia, mild hyperglycemia, elevated BUN, elevated calcium, low albumin, and slightly elevated ALT.

Image Interpretation

The stomach was dilated in this patient with anechoic fluid. The fluid dilation continued into the pylorus. Gas artifact was noted in the upper gastrointestinal and stomach. This obscured some visibility. The small intestine was dilated and was followed by empty small intestine. The midabdomen revealed echogenic material in what appeared to be the small intestine. The descending colon presented some stool.

Sonographic Differential Diagnosis

Upper gastrointestinal obstructive pattern. Suspect foreign body.

DX

Foriegn body obstruction; a pistachio.

Outcome

The patient underwent an abdominal exploratory in which a pistachio was removed from the jejunum via uncomplicated enterotomy. The patient recovered uneventfully.