case_images: PMC10808648_01
case_images: Lateral (A,B) and ventrodorsal (C,D) abdominal radiographic projections of the dog. The images on the left (A,C) were obtained before decompression, and those on the right (B,D) were obtained immediately after decompression. Before decompression, massive pneumoperitoneum is characterized by the outlining of the peritoneal cavity with massive amount of gas and outlining of both sides of the small bowel wall with peritoneal gas (open arrow); a decreased overall abdominal serosal detail is also noted. On the ventrodorsal (C) radiograph, a radiopaque stripe (arrow) is identified in the mid-abdomen, which is considered a peritoneal ligament. After decompression, the abdominal distension decreased, but a large amount of free gas is still present. Cranial displacement of the diaphragm indicates increased intraperitoneal pressure.
case_images: fvets-10-1281966-g001.jpg
case_images: PMC10808648_01_fvets-10-1281966-g001.jpg
case_images: fig1
case_images: Abdominal radiography (Titan 2000; Comed Medical Systems Co., Ltd., Seoul, Korea; 82 kVp, 10.2 mAs, 320 mA) revealed a large volume of free gas in the peritoneal space (Figures 1A,C) with marked abdominal distension and cranial displacement of the diaphragm. Emergent needle decompression and peritoneal effusion sampling were performed; however, despite improvement in respiration and reduction in abdominal distension, a large amount of free gas was persistent (Figures 1B,D).
case_images: Transverse (A-C) multiplanar post contrast computed tomography (CT) images of the patient with a soft tissue algorithm (WL 45, WW 450) (A,C) and lung algorithm (WL -400, WW 1500) (B). Intraoperative image (D) of the dog. The gastric mass (M) with homogeneous contrast enhancement is seen in the cardia. A low attenuating cleft (arrowhead) adjacent to the gastric mass is presumed to be the perforation site. Notice the gastric mass (M) and perforation site (open arrow) after the separation of the omental adhesion. A large volume of free gas (asterisk) is presence and displaces the liver medially. Note that the structure thought to be the omentum covers the stomach and numerous gas (arrow) present between them. Multiple gas bubbles (dashed arrow) are trapped between peritoneum. (A,B) images are on the same level but in different algorithms. CT images, same kv, mAS, and thickness as in the document. L: liver, M: gastric mass, Cr: cranial, Cd: caudal.
case_images: fvets-10-1281966-g002.jpg
case_images: PMC10808648_01_fvets-10-1281966-g002.jpg
case_images: fig2
case_images: Systems, Milwaukee, WI, United States) was used to administer 600 mg iodine/kg iohexol (Omnihexol 300; Korea United Pharmaceutical, Seoul, Korea). In post-contrast images, we found a gastric mass with homogeneous enhancement, measuring approximately 3.7 x 5.0 x 5.5 cm and extending from the cardia to the fundus of the stomach (Figure 2). Small gas bubbles were present between the omentum and gastric mass (Figures 2A,B). A substantial amount of free gas was present in the peritoneal cavity (Figure 2), causing compression and centralization of the abdominal organs (Figures 3A-C). A gastric perforation site (Figure 2D) of approximately 2.2 cm was identified near the gastric mass.
case_images: Sagittal (A), dorsal (B,D) and transverse multiplanar (C) post contrast computed tomography (CT) images of the patient with a soft tissue algorithm (WL 45, WW 450) (A,C,D) and lung algorithm (WL -400, WW 1500) (B). Note that a large amount of gas (asterisks) compresses the intra-abdominal organs in the gravity dependent direction (open arrows) and displaces them centrally on the dorsal plane. Diffuse peritoneal effusion (#) and the fat stranding signs are observed throughout the abdominal cavity, with the fat stranding sign being particularly pronounced around the stomach (arrows).
case_images: fvets-10-1281966-g003.jpg
case_images: PMC10808648_01_fvets-10-1281966-g003.jpg
case_images: fig3
case_images: A substantial amount of free gas was present in the peritoneal cavity (Figure 2), causing compression and centralization of the abdominal organs (Figures 3A-C). Diffuse peritoneal effusion and fat stranding were observed throughout the peritoneal cavity, particularly around the stomach (Figure 3D).