Case Report: Surgical Treatment of Duodenogastric Intussusception with Pancreatic Involvement in a Dog
An intussusception of gastrointestinal tract is uncommon in adult dogs and duodenogastric intussusception with pancreatic involvement is a very rare form in veterinary medicine. There is considerable variation in etiology and most of the cases are idiopathic. The prognosis and treatment outcome are variable depending on the severity of vascular compromise, abdominal organ association and underlying causes.
A 6-year-old intact female crossbred dog was referred because of 4 days of history of vomiting and anorexia. The dog was diagnosed with pancreatitis with severe azotemia. Repeated ultrasonography revealed typical views of a duodenogastric intussusception.
The intussusception was identified with midline celiotomy. The pylorus, proximal duodenum and the segment of right pancreatic limb were prolapsed into the stomach. The intussusception was reduced manually and a duodenopexy was performed. There was no polyp in the gastropyloric outflow and a full-thickness biopsy was performed in the thickened pyloric region.
The dog recovered uneventfully from surgery and the biopsy revealed submucosa edema without evidence of malignancy. Upon follow-up, the dog has had no evidence of recurrence of duodenogastric intussusception for over 1 year.
As a rarity of duodenogastric intussusception, this case is unique in the presence of pancreatitis due to gastroduodenal outflow obstruction and pancreatic involvement. Severe vomiting is the identifiable condition being the predisposing factor in both terms of primary and expectable recurrent evidences of this intussusception. Manual reduction and duodenopexy were accomplished for treatment and recurrent prevention.