Intramural gastric abscesses in a dog

I. Otero Balda, M. Augusto, C. Lassaigne, M. P. Maurin

• Case Background: A 6-year-old Labrador retriever presented with chronic vomiting and anorexia. Ultrasound and CT scans revealed two large intraparietal structures in the stomach, leading to a diagnosis of intramural gastric abscesses (IGAs).

• Imaging findings:

  • Abdominal Ultrasound (AUS): The ultrasound revealed two large ovoid to fusiform well-defined structures in the gastric fundic and pyloric regions. The largest of these structures measured approximately 5.4 cm in diameter, extending eccentrically from the region of the pylorus. This region contained multiple static hyperechoic foci and did not display any signal on power Doppler, leading to the suspicion of it being intraparietal. Infiltrative gastric wall disease, gastric neoplasia with necrotic changes, or gastritis were considered as differentials. Ultrasound-guided fine-needle aspiration (US-guided FNA) of these regions was performed, and cytology was compatible with marked, apparently non-septic, neutrophilic inflammation with no obvious criteria of malignancy.

  • Triple Phase CT: The CT scan identified two large homogeneously fluid attenuating intramural gastric structures: one along the greater curvature in the fundus and another one extending from the lesser curvature to the pyloric antrum region dorsally, markedly impinging on the pyloric lumen. There was also moderate regional lymphadenopathy

• Surgical Intervention: The dog underwent surgery where the abscesses were debrided and partially resected through a gastrotomy approach. Histopathology confirmed neutrophilic inflammation and the presence of a vegetal foreign body.

• Postoperative Recovery: The dog showed no recurrence of clinical signs at a 22-month follow-up, indicating successful management of the condition.

The report emphasizes the importance of CT imaging for diagnosis, the potential role of foreign bodies in the aetiopathogenesis, and the successful surgical management of such cases.

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