Intestinal Obstruction

 
 

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.

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.

 

DX

Foriegn body obstruction; a pistachio.

Sonographic Differential Diagnosis

Upper gastrointestinal obstructive pattern. Suspect foreign body.

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.

Outcome

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

Video

Patient Information

Patient Name : Jazz Rodriguez
Age : 1 Year
Gender : Male, Neutered
Species : Feline

Blood Chemistry

  • Albumin, Low
  • ALT (SGPT), High
  • BUN high
  • Calcium, High
  • Glucose, High

CBC

  • Eosinophils, Low
  • Hematocrit, High
  • Platelet Count, High

Images

jazz_stomachjazz_pistachio_nut

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