Imaging diagnosis - intramural hematoma, jejunal diverticulum and colic in a horse.

摘要

A 21-year-old Thoroughbred gelding was examined because of acute colic [place and date not given]. Over the past eight years, the gelding had exhibited colic signs on 24 different occasions. All previous colic episodes were responsive to medical management, and a definitive diagnosis was never reached. Physical examination showed mild abdominal pain, tachycardia, decreased borborygmi and mild dehydration. Transcutaneous abdominal ultrasonography was performed 6 h after the onset of colic signs due to continued discomfort. In the right ventral abdomen, an elongated, heteroechoic, lentiform intramural jejunal mass was observed. The mass was approximately 60 cm in length. Anechoic-loculated areas were present within the mass, as well as echoic areas which had a hazy swirling pattern when imaged in real time. The swirling pattern of echoic fluid within the intestinal wall was unrelated to the movement of the horse or adjacent intestinal motility and was clearly delineated from the ingesta within the lumen. A tentative diagnosis of intramural haemorrhage with clot formation in the jejunum and partial obstruction of the small intestine was made. Three days after presentation, the horse was euthanized. At postmortem examination, a 60-cm-long intramural haematoma in the mid-jejunum was observed. The haematoma was hemi-circumferential at the site of the diverticulum, and the intestinal lumen contained moderately impacted fibrous ingesta at this location. Histopathologically, there was severe diffuse atrophy of the muscular tunic between the lamina propria and tunica serosa.