This case was presented in the Summer of 2020 at our Virtual IDEXX Diagnostic Imaging CE event.
History: Anorexia and lethargy for 1 week.
Images: 3 radiographs were provided
How did we grade this during the Virtual IDEXX Diagnostic Imaging CE event?
|Right cranioventral abdominal soft tissue mass effect with centrally tracking linear gas and punctate mineral foci, also linear||3|
|Gas dilated small intestines||1|
|Poor, wispy abdominal serosal detail||1|
|Small intestinal mass likely arising from distal jejunum or ileum, neoplasia prioritized (such as carcinoma or lymphoma) much more likely than granulomatous disease||2|
|Small intestinal mechanical ileus (gravel sign indicates chronic partial obstruction, though recent development of complete obstruction possible)||1.5|
|Peritoneal effusion secondary to neoplasia or peritonitis||0.5|
For a mass of this size and location, the main differentials would be an intestinal mural mass (carcinoma or lymphoma primarily) though a splenic or potentially mesenteric lymphatic mass could have this appearance. The presence of the linear granular mineral material leads to the prioritization of an intestinal lesion leading to chronic partial obstruction causing the accumulation of this mineral material within the lumen of the intestine throughout the length of this lesion or immediately orad to this lesion (gravel sign).