An aged Bengal slow loris (Nycticebus coucang bengalensis) was examined for progressive weight loss. A firm but depressible mass was palpable in the left cranial abdominal quadrant in close association with the liver. Radiographs showed right liver enlargement, calcification in the area of the liver, and what was erroneously interpreted as air from aerophagia in the stomach delineating ingesta. A fine needle aspirate of the mass demonstrated mixed flora suggestive of gastrointestinal contents. Ultrasonography was non-diagnostic due to air interference. A subsequent contrast study and gastroscopy demonstrated the “mass” to be the stomach enlarged by gastric pneumatosis. The loris was euthanized due to clinical decline. At necropsy, the gastric wall was thickened by submucosal emphysema. Histologically, submucosal air bubbles were often surrounded by mild granulomatous inflammation. Additional findings included a hepatocellular carcinoma, a calcified leiomyosarcoma in the terminal esophagus, and unrelated geriatric changes.
Gastric pneumatosis is a rare problem in veterinary1 and human medicine2 where air is trapped within the layers of the stomach. More frequently reported is pneumatosis intestinalis or pneumatosis coli.3,4 Any underlying condition that allows gas or gas-producing bacteria to enter the submucosa and dissect the tissue layers could initiate the process. Examples are necrotizing gastrointestinal disease, tumors, trauma, and gas trapping from bacterial growth after intestinal surgery. While there were both esophageal and hepatic cancers in this animal, no definitive underlying cause for the pneumatosis was identified.
This is the first known report in a loris and the second known report in a non-human primate.5
1. Lang, L.G., H.H. Greatting, and K.A. Spaulding. 2011. Imaging diagnosis-gastric pneumatosis in a cat. Vet. Radiol. Ultrasound. 52:658–660.
2. Earnest, D., and D.J. Schneiderman. 1989. Other diseases of the colon and rectum. In: Sleisenger, M.H. and J.S. Fordtran (eds.). Gastrointestinal Disease: Pathophysiology Diagnosis Management. W.B. Saunders Co.: Philadelphia Pennsylvania. Pp.1595–1600.
3. Aste, G., A. Boari, and C. Guglielmini. 2005. What’s your diagnosis? Pneumatosis coli in a dog. J. Am. Vet. Med. Assoc. 277:1407–1408.
4. Russell, N.J., D. Tyrrell, P.J. Irwin, and C. Beck. 2008. Pneumatosis coli in a dog. J. Am. Anim. Hosp. Assoc. 44:32–35.
5. Calle, P.P. 1986. Gastric pneumatosis in a red ruffed lemur. J. Am. Vet. Med. Assoc. 189:1212–1214.