2007 Radiology Exam - Abdomen Case 1

“Angus”

• Sg: 12yr Labrador Retriever MC
• Hx: Found collapsed and unable to rise
• Rads: 2 views of the abdomen

See images below. Click to enlarge.

Candidates received points for:

• Abnormal Radiographic Findings: poor serosal detail; abnormal gas free in peritoneal cavity, close to stomach and between liver and diaphragm; corrugated intestinal loop caudal to stomach, probably transverse colon; elongated/enlarged, slightly rounded liver.
• Radiographic Diagnoses of: Pneumoperitoneum, differentials including GI ulcer or neoplasm with perforation/rupture, or migrating foreign body; likely (septic) peritonitis; spasm and/or inflammation of transverse colon or other intestines, either related to perforation or secondary to regional inflammation; hepatomegaly secondary to steroid, neoplastic, or other hepatopathy.
• +/- abdominal ultrasound (to evaluate for mass in GI tract, liver; collect abdominal fluid to evaluate for bacteria), thoracic radiographs (to evaluate for mets).

Outcome:

• Additional history: pet had been on metacam chronically for arthritis.
• Surgery: 2 liters dark red fluid with ingesta free in abdomen, 1cm gastric body wall perforating ulcer, hyperemia of entire GI tract, left medial liver lobe mass ~6cm
• Bx: no gross evidence of neoplasia; histopath cancelled – pet arrested