Data_Sheet_1_Case report: Surgical treatment of pyloric obstruction with intramural gastric abscess induced by fragmented crystalline foreign materials in a dog.PDF

An 11-year-old neutered male Maltese presented with a 2-day history of persistent vomiting and lethargy. Abdominal ultrasonography revealed a hypoechoic marginal mass with gastric wall thickening in the pyloric region of the stomach. Computed tomography revealed a non-contrast-enhanced mass in the pyloric antrum causing pyloric outflow obstruction. Imaging studies suggested a tumor and surgical treatment was performed due to the deterioration of the patient’s condition. The pyloric mass was excised, and the stomach and duodenum were anastomosed via pylorectomy and gastroduodenostomy (Billroth I procedure). Postoperatively, the pyloric outflow obstruction resolved, clinical symptoms improved, and no significant complications were observed. Histopathological examination revealed a gastric abscess characterized by a mass-like area with abundant necrosis. Angular fragmented crystalline foreign materials were observed within the lesion. To our knowledge, this is the first reported case of an intramural gastric abscess caused by fragmented crystalline foreign materials in a dog. Although rare, this case highlights the importance of considering gastric abscesses in the differential diagnoses of gastric masses. If the cause of the gastric abscess is an invisible foreign material, postoperative follow-up should be considered to monitor for potential recurrence.

本病例为一只11岁去势公马尔济斯犬（Maltese），因持续性呕吐与精神沉郁2天前来就诊。腹部超声检查显示其胃幽门区存在低回声边缘性肿块，伴随胃壁增厚。计算机断层扫描（computed tomography）显示幽门窦内存在无强化肿块，引发幽门流出道梗阻。影像学检查提示为肿瘤性病变，且因动物病情恶化，遂实施手术治疗。术中切除幽门肿块，通过幽门切除术（pylorectomy）与胃十二指肠吻合术（gastroduodenostomy，毕Ⅰ式手术（Billroth I procedure））完成胃与十二指肠的吻合。术后幽门流出道梗阻得以解除，临床症状得到改善，未观察到明显并发症。组织病理学检查显示，病灶为伴大面积坏死的肿块样区域，确诊为胃脓肿（gastric abscess），病灶内可见角状碎裂结晶状异物。据我们所知，这是首例报道的犬因碎裂结晶状异物引发壁内胃脓肿（intramural gastric abscess）的病例。尽管此类病例较为罕见，但本案例强调了在胃肿块的鉴别诊断中需考虑胃脓肿的重要性。若胃脓肿的致病原为不可见异物，则应考虑术后随访以监测潜在复发风险。