1. Dr. Norman Ackerman served the University of Florida, College of
Veterinary Medicine with distinction as Professor of Radiology from 1979 to
1994. A concerned teacher of veterinary students and residents of all
disciplines, Dr. Ackerman also reached the veterinary scientific community
through his writing. His numerous clinically pertinent publications are still
today a vital part of the veterinary literature; therefore, it is appropriate this
site perpetuates Dr. Ackerman’s dedication to teaching. This site is
presented in recognition of Dr. Norman Ackerman and his contributions to
the field of veterinary diagnostic imaging.
Sponsorship of the display supports the Dr. Norman Ackerman Memorial
Fund, dedicated to the teaching of diagnostic imaging residents at the
University of Florida College of Veterinary Medicine.
April
2015
3. History
and
case
presenta2on
• Ellie
presents
to
your
clinic
with
a
72
hours
history
of
vomi2ng
and
inappetence
with
recent
onset
of
diarrhea.
• On
today’s
physical
examina2on,
Ellie
is
bright,
alert
and
responsive.
Her
heart
and
respira2on
rates
are
slightly
elevated
(260
bpm
and
60
bpm,
respec2vely)
and
her
temperature
is
104.2
F.
When
palpated,
her
abdomen
felt
soL
and
pliable
and
didn’t
elicit
pain.
• Your
plan
includes
radiographs
of
the
abdomen.
4.
5.
6.
7. There
is
a
moderate
amount
of
gas
within
the
stomach.
Par2cularly,
a
moderately
gas-‐distended
pylorus
is
noted
in
all
the
radiographic
projec2ons.
Findings
8. The
small
bowel
loops
contain
a
moderate
amount
of
gas
as
well
and
appear
plicated.
Findings
9. However,
the
small
intes2nal
segments
measure
within
normal
limit
for
diameter
(<12mm
mucosa
to
mucosa
of
gas-‐filled
loops
and
≤2
2mes
the
diameter
to
L2
cranial
vertebral
end
plate
height
ra2o*).
*Morgan
JP,
1981;
Adams
WM,
2010.
Findings
10. The
abdominal
serosal
detail
is
within
normal
limits
with
no
evidence
of
free
peritoneal
gas.
12. Conclusion
You
found
moderately
gas-‐filled
stomach
and
small
intes2nes.
Par2cularly,
a
moderately
gas-‐distended
pylorus
is
noted
in
all
the
radiographic
projec2ons.
In
addi2on
you
noted
that
several
small
intes2nal
segments
make
abrupt
turns,
causing
a
bunched
posi2oning
of
the
small
bowel
in
the
ventral
mid-‐abdomen,
sugges2ng
plica2on.
Plicated
small
intes2nal
loops
are
highly
sugges2ve
of
linear
foreign
body.
The
pa2ent
underwent
exploratory
laparotomy
that
revealed
a
string-‐like
foreign
body
firmly
anchored
near
the
pylorus.
Plica2on
was
noted
along
the
full
length
of
the
jejunum.
Approximately
20
cm
of
the
jejunum
was
resected
and
the
opposite
ends
anastomosed
together
due
to
decreased
vascular
pulses
at
palpa2on
and
presence
of
black
and
bruised
appearance
of
the
mid-‐jejunum
during
surgical
inspec2on.
No
free
fluid
was
observed
in
the
abdominal
cavity
nor
other
abnormali2es
during
the
procedure.
Ellie
recovered
successfully
from
surgery.
13. ...
your
pa2ent
had
a
linear
foreign
body...
Feline
pa2ents
with
gastrointes2nal
foreign
bodies
may
present
with
a
wide
range
of
clinical
signs:
vomi2ng,
diarrhea,
regurgita2on,
ptyalism,
inappetence,
anorexia,
depression,
dehydra2on,
abdominal
pain
and/or
disten2on,
palpable
firm
segments
of
the
intes2nes,
palpable
intes2nal
dila2on,
etc.
Linear
foreign
body
obstruc9on
is
a
par2cular
form
of
intes2nal
obstruc2on
seen
commonly
in
cats.
The
most
common
causes
are
sewing
threads
alone
or
in
combina2on
with
sewing
needles
and
also
strings,
threads,
nylon
stockings
or
carpet
fibers.
The
linear
object
becomes
fixed
around
the
base
of
the
tongue
or
the
pylorus
and
as
the
intes2nal
peristal2c
wave
a_empt
to
move
the
object
aborally,
the
intes2ne
gradually
gathers
up
in
a
pleated
fashion
on
the
foreign
object
that
soon
can
become
embedded
in
the
mesenteric
border
of
the
small
intes2ne
and
can
erode
through
the
intes2nal
wall,
leading
to
local
or
generalized
peritoni2s
due
to
leakage
of
intes2nal
contents.
Bebchuk,
2002
14. ...
linear
foreign
bodies:
radiographic
findings...
In
case
of
linear
foreign
body
obstruc2on,
intes9nal
loops
may
not
become
severely
distended,
since
the
obstruc2on
is
not
complete,
but
gas
commonly
becomes
trapped
in
pockets
formed
by
the
pleats.
As
a
result
the
small
intes2ne
present
a
pa_ern
of
round,
tapered,
short
tubular
and
some2mes
crescent
or
comma
shaped
gas
bubbles
on
survey
radiographs.
In
the
cat,
the
plica2on
of
the
bowel
can
can
cause
a
clumped
or
bunched
posiBoning
of
the
small
intes2ne.
The
displacement
of
the
small
bowel
in
the
middle
or
right
side
of
the
abdomen
typically
seen
on
radiographs
in
obese
cats
should
not
misinterpreted
as
linear
foreign
body!!!
In
the
normal
fasted
cat,
gas
is
rarely
present
in
the
small
intes2ne.
Animals
non
fasted
with
no
GI
disease
or
animals
stressed
by
handling
or
dyspneic
animals
may
have
a
more
air-‐containing
small
bowel.
However,
most
pa2ents
maintain
a
small
intes9nal
linear
pa=ern
with
gas
in
a
con9nuous
column
except
where
interrupted
by
a
peristal9c
wave.
Riedesel,
2013.
15. GASTROINTESTINAL
FOREIGN
BODIES
GastrointesBnal
foreign
bodies
in
dogs
and
cats:
a
retrospecBve
study
of
208
cases.
Hayes
G.
Journal
of
Small
Animal
PracBce.
2009
50,
576-‐583.
Gastrointes2nal
foreign
bodies
are
commonly
encountered
in
small
animal
prac2ce
and
may
present
with
a
wide
range
of
clinical
signs
depending
on
the
loca9on,
the
degree
and
the
dura9on
of
the
obstruc2on.
In
dogs
linear
foreign
bodies
are
most
commonly
anchored
at
the
level
of
the
pylorus
with
the
foreign
material
extending
into
the
proximal
jejunum.
In
cats
linear
foreign
bodies
are
more
frequent
than
in
the
canine
popula2on
and
the
majority
of
them
are
found
anchored
around
the
base
of
the
tongue.
A
longer
dura2on
of
clinical
signs,
the
presence
of
linear
foreign
body
and
mul2ple
intes2nal
procedure
have
been
associated
with
significantly
increased
mortality.
Prompt
presenta2on,
diagnosis
and
surgical
interven2on
showed
to
improve
the
outcome
of
gastrointes2nal
obstruc2on
by
foreign
bodies.
