Survey of the use of radiography vs. ultrasonography in the investigation of gastrointestinal foreign bodies in small animals

A question frequently asked by clinicians who are treating small animals suspected of having gastrointestinal foreign bodies is whether one imaging test such as survey radiography or ultrasonography is sufficient to make the diagnosis. A study was undertaken to try and answer this question. Survey abdominal radiography and ultrasonography was performed on 16 small animals (11 dogs, five cats) with clinical signs of an obstruction because of a confirmed gastrointestinal foreign body. The majority of the foreign bodies (14/16) were confirmed by surgical removal and were located in the small intestine. A gastric foreign body was retrieved endoscopically and a colonic foreign body was passed in the feces. Radiographically identifiable foreign bodies were evident in nine animals. Small intestinal overdistension was present radiographically in seven animals. Ultrasonography detected a foreign body in all 16 animals. The foreign bodies were identified by their distal acoustic shadowing and variable degrees of surface reflection. An intestinal perforation was detected sonographically but not radiographically. The value of additional sonographic findings including thickening of the gastrointestinal wall and loss of layering, free peritoneal fluid, and lymphadenopathy in these animals is discussed. The findings in this series suggest that in a small animal with a gastrointestinal foreign body, ultrasonography alone could be used to make the diagnosis and may be a more appropriate choice than survey radiography.