Veterinary Medicine - August 2007 - (Page 525)

Linear foreign bodies O P E E R - R E V I E W E D Ultrasonography is accurate for diagnosing linear foreign bodies and provides information about GI function. In this case, the compression technique elucidated an area of smallbowel plication. To prevent potential complications such as bowel rupture and peritonitis, carefully consider that friable intestine may be present when you perform compression in patients with severe abdominal pain. We have used abdominal compression radiography in several cases with no complications; however, we recommend compressing the abdomen gently. tract, making them contraindicated in debilitated and dehydrated patients.4,15 Thus, although vomiting has been reported within 15 to 30 minutes after administration of undiluted iohexol (a nonionic iodinated positive contrast agent) in experimental studies in cats, we recommend nonionic contrast media.16 Contrast studies are time-consuming. In some cases, further attempts to define the specific site and type of obstruction with contrast media may only delay and complicate surgery or further compromise the patient.4 Positive contrast upper GI radiography Another technique that can be used to diagnose linear foreign bodies is a positive contrast upper GI study, but it was unnecessary in this case. These studies can be used to evaluate small intestinal foreign bodies, strictures, mucosal disease, and abnormal transit times.1,4,10 A GI study can be done with either micropulverized barium sulfate solution or water-soluble iodinated products. Barium sulfate suspensions are radiopaque, provide excellent mucosal detail, and are inexpensive.13,14 If leakage into the peritoneal cavity occurs, barium combined with enteric contents may cause granulomas or adhesions.4 By comparison, iodinated ionic solutions have a rapid transit time, are nonirritating to serosal surfaces, are rapidly resorbed following extraluminal leakage, and can be followed quickly by endoscopic evaluation if indicated.15 However, iodinated ionic solutions are hypertonic, which cause an influx of fluid into the GI Ultrasonography Ultrasonography has become increasingly important in diagnosing GI disease.17,18 Ultrasonographic studies are noninvasive, accurate for diagnosing linear foreign bodies, and provide information relative to GI function and disease location. 19,20 Abnormal echogenic material within the lumen indicates a foreign body2; however, the appearance of foreign material will vary depending on its physical properties. Linear foreign bodies are linear structures located eccentrically within the lumen of thickened, plicated bowel.19 The integrity of the intestinal wall can be evaluated based on the presence of fluid or air outside the GI tract. In the absence of free gas, a combination of ultrasonographic findings such as bright mesenteric fat, peritoneal effusion, fluid-filled stomach and intestines, wall thickening, reduced motility, and loss of wall layering (the mucosa, submucosa, muscle, VETERINARY MEDICINE August 2007 525 http://www.purinavets.com

Table of Contents Feed for the Digital Edition of Veterinary Medicine - August 2007

Contents A Veterinary Medicine Interview Veterinary Voices Idea Exchange Diagnosis and Treatment of Solar Dermatitis in Dogs Diagnostic Imaging for Linear Foreign Bodies in Cats Overcoming the Diagnostic and Therapeutic Challenges of Canine Immune-Mediated Thrombocytopenia Ophthalmic drugs: What’s new? CE Form Product Preview Advertiser Index Marketplace/Classifieds Mind Over Miller

Veterinary Medicine - August 2007

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