Dog, male intact. One and half year of age.Presented at the emergency service with a history of vomiting since 3 days. The dog was painful in cranial abdomen, febrile, was not eating or drinking Radiographs of the abdomen were taken. Left lateral and VD view of the abdomen. No abnormalities were detected, a part from mild distention of the proximal duodenum, gas filled.
- Considering the persistent clincal signs, the dog underwent ultrasonographic examination two subsequent days performed by two different diplomate radiologists. No abnormalities were detected.
- Then a CT scan was planned.
CT study, post contrast, soft tissue window. Transverse scan and reconstruction in the dorsal plane, adapted in the direction and optimized for the visualisation of the foreign body. A long wood stick with a second, shorter stick are visible. The longest one is crossing the stomach, perforating the large curvature and protruding from the 11th intercostal space, causing a focal soft tissue swelling. Radiologic diagnosis
- Gastric foreign body (wood stick) with perforation from the stomach to the left abdominal wall.
- Mild amount of free abdominal gas.
- Focal peritonitis next to the gastric wall.
- Mild soft tissue swelling on the left thoracic wall, in correspondence to the tip of the stick.
- The dog unterwent surgery and the diagnosis was confirmed. He recovered without complications.
Comments
- Detection of migrating or perforating wooden foreign bodies represents clinical challange.
- Wood is typically radiolucent, so wooden foreign bodies generally cannot be seen on survey radiographs.
- On ultrasound examination, the acoustic properties of wooden foreign bodies vary with their physical density. They are commonly described as hyperechoic, however, wooden fragments can become progressively less echogenic over time and may eventually be no longer distinguishable from the surrounding inflammation.
- It has been postulated that wooden foreign bodies retained in the body for long periods absorb fluid, altering their imaging characteristics.
- In some cases, there may be localised periosteal response associated with one of the caudal ribs or soft tissue swelling in this region.
- With computed tomography, splinter soaked for some days appeares less radiodense than muscle, splinter soaked for some months were described more radiodense than muscle. Their appearance is anyway extremely variable.
- Even retrospectively, neither the free abdominal gas nor the soft tissue swelling in the intercostal space were appreciated on the radiographs.
