Student Case Presentation
A Jejunal-jejunal Intussusception in a 2-year-old Angus Bull
| Date/Time: |
9/12/2024 15
|
| Presenter: |
Carla Gutierrez |
| Veterinary School: |
VA |
Abstract:
A 2-year-old Angus bull was presented on emergency to a referral Veterinary Teaching Hospital with non-specific signs of 2-3 day duration. The referring veterinarian treated with transdermal Flunixin Meglumine, sulfamethazine boluses, and magnesium oxide boluses with no improvement. Physical exam revealed a dull mentation, dehydration, reduced rumen motility, tachycardia, and a ventrally distended abdomen. Upon rectal palpation, there was malodorous melena feces and a firm mass felt in the ventral abdomen. Bloodwork revealed an obstructive pattern and confirmed the dehydration observed on physical exam. Abdominal ultrasound diagnosed multiple 4-6 cm dilated loops of small bowel, no peristalsis, fluid present in the intestines, and a significantly dilated gallbladder. After diagnostics and physical exam, the top differential was hemorrhagic bowel syndrome with a formed clot in the small intestines.
The following morning, an abdominal exploratory was performed and an intussusception, suspected to be ileocecal, was diagnosed. Due to poor surgical prognosis, the bull was euthanized. A necropsy identified a 0.5-meter section of jejunum telescoped into an adjacent section of jejunum, with a 5 cm long perforation in the outer portion of the intussuscipiens. There were also mild coccidia found in the enterocytes and lamina propria of the intestines and mild rumenitis.
Unfortunately, no definitive cause was identified for the intussusception. It is possible inflammation caused by coccidia may have been an inciting factor. With the scarcity of reports for intussusceptions, it is important for veterinarians to review the various ways such cases may present so that they can better identify intussusceptions. Like with other abdominal obstructions, signs are often non-specific, thus emphasizing that veterinarians must be systematic in their evaluation of patients in order to narrow down a diagnosis.
