Juvenile, Female, Canine American Pitbull Terrier

History: Approximately 3 days ago, the patient ingested pineapple leaves. The patient was seen to defecate a single pineapple leaf 2 days ago. Since then the patient has been lethargic, and anorexic, with frequent vomiting.

The patient is lethargic with tacky mucous membranes. There are mild decreases in Na, K and Cl; the remainder of the parameters were normal.

Images: Left lateral, right lateral and ventrodorsal radiographs of the abdomen were acquired.

Findings: There is a small amount of gas and fluid dilation of the stomach. The stomach contains a small amount of granular mineral material in the pyloric outflow region. This is seen extending into the descending duodenum on the ventrodorsal projection. There is granular soft tissue opacification seen within the region of the duodenum on the left lateral projection however some of this could be fecal material. The small intestines are otherwise unremarkable and not significantly distended. No other abdominal abnormalities are noted. The portion of the thorax included on the study is within normal limits.

Conclusions: This type of distention of the stomach and the mineral material seen within the pyloric outflow region and the descending duodenum is most consistent with a proximal small intestinal mechanical obstruction and this is the primary consideration.

Recommendations/Follow up: An exploratory laparotomy is justified and was performed. A barium study or abdominal ultrasound examination could be considered but the survey radiographs support an exploratory. A cloth toy was found obstructing the duodenum and was removed successfully, resulting in a happy ending.

2 comments

  1. Findings: The stomach is moderately distended with fluid and a small amount of gas, which moves with changes in laterality. On the VD view, within the fundic region of the stomach, there is a well-defined angular margin along the left lateral aspect of a soft tissue opaque structure within the stomach that is outlined with gas. There is heterogeneous soft tissue and mineral opaque material seen within the length of the descending colon and the orad ascending duodenum. The duodenum is mildly dilated throughout its visible length.

    Synthesis: Proximal small intestinal mechanical obstruction and/or intermittent pyloric outflow obstruction secondary to ingestion of foreign material. The material within the stomach may represent a large piece of pineapple fruit given its appearance. Given the large size of the gastric material, exploratory laparotomy is recommended for removal.

  2. The stomach is largely distended with fluid and ingesta. There is a mineral-opaque object in an intestinal lumen visible on lateral projections ventral to L4-5, and visible on the VD on the left hand side lateral to L4

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