A six-month-old terrier mix is presented with three days of vomiting, diarrhea, and lethargy.

Based on the radiograph and ultrasonography image from the abdomen, which one of the following choices is the most likely diagnosis?

Sorry.  You chose E, but the correct answer is B. Intussusception

This puppy has jejunal intussusception. There are markedly dilated bowel loops in the caudal portion of the abdomen.

More normal sized loops are gas-filled in the cranial abdomen. The peritoneal detail is poor, likely because of his young age.

Ultrasonography diagnosed the intussusception. You can see the bowel within bowel, or concentric rings of intestine in both the longitudinal and the cross-sectional image.

There is often mesenteric fat pulled into the intussusception, which appears hyperechoic on the transverse image. It is more rare to see a jejunal intussusception.

Most intussusceptions involve the ileum and colon. A more proximal obstruction results in focal bowel dilation such as in this case.

Distal obstruction often causes dilation of the entire proximal or oral small intestine.

Click here to see examples of canine abdominal radiographs.

Refs: Cote, Clinical Veterinary Advisor-Dogs and Cats, 3rd ed. pp. 569-71, Fossum, Small Animal Surgery 4th ed. pp 524-8. Radiographic interpretation and images courtesy, Dr A. Zwingenberger and Veterinary Radiology. Normal radiograph links courtesy, Imaging Anatomy Univ. of Illinois Vet Med.

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