Todayโs path rounds are on ๐ข๐ง๐ญ๐ฎ๐ฌ๐ฌ๐ฎ๐ฌ๐๐๐ฉ๐ญ๐ข๐จ๐ง! This topic is related to a case I had recently.
๐๐ก๐๐ญ ๐ข๐ฌ ๐ข๐ญ?
๐๐ง๐ญ๐ฎ๐ฌ๐ฌ๐ฎ๐ฌ๐๐๐ฉ๐ญ๐ข๐จ๐ง is when one piece of the intestine (called the ๐ข๐ง๐ญ๐ฎ๐ฌ๐ฌ๐ฎ๐ฌ๐๐๐ฉ๐ญ๐ฎ๐ฆ) telescopes into another piece of intestine (called the ๐ข๐ง๐ญ๐ฎ๐ฌ๐ฌ๐ฎ๐ฌ๐๐ข๐ฉ๐ข๐๐ง๐ฌ), forming a multi-layered intestinal segment.
๐๐ก๐จ ๐ ๐๐ญ๐ฌ ๐ข๐ญ?
All species can get this!
๐๐ก๐๐ญ ๐๐๐ฎ๐ฌ๐๐ฌ ๐ข๐ญ?
This issue can be caused by linear foreign bodies like string or yarn in the intestine, parasites, previous intestinal surgery, inflammation of the intestine or even tumours. Basically, anything that can disrupt the normal gut motility of a section of intestine. When the gut stops moving in one area, the ๐จ๐ซ๐๐ (closer to the mouth) segment of intestine continues to move, causing it to basically crawl into the non-motile intestine, forming the intussusception.
๐๐ก๐ฒ ๐๐ซ๐ ๐ญ๐ก๐๐ฒ ๐ ๐ฉ๐ซ๐จ๐๐ฅ๐๐ฆ?
When a piece of intestine is pulled into another section of intestine, it compresses the veins that drain the internalized section. This causes ๐๐จ๐ง๐ ๐๐ฌ๐ญ๐ข๐จ๐ง (static, non-flowing blood in the vessels) and ๐๐๐๐ฆ๐ (excess fluid in the tissue) of the internalized section. Eventually, this leads to tissue death for the internalized section, potentially causing release of intestinal contents into the abdomen and causing a massive infection called ๐ฉ๐๐ซ๐ข๐ญ๐จ๐ง๐ข๐ญ๐ข๐ฌ. Additionally, intestinal contents generally cannot move through an intussusception, causing severe abdominal pain for the animal.
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐๐ข๐๐ ๐ง๐จ๐ฌ๐๐?
Intussusceptions can be diagnosed by ultrasound, where you can see a โtargetโ like image made by the layering of the intestine. X-rays may also help, especially when the animal is given ๐๐๐ซ๐ข๐ฎ๐ฆ orally, as it shows up as white on an X-ray. With barium, you can see dilation of the intestine with backed up intestinal contents before the intussusception, and minimal intestinal contents after the intussusception.
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐ญ๐ซ๐๐๐ญ๐๐?
These are almost always treated surgically, by doing a ๐ซ๐๐ฌ๐๐๐ญ๐ข๐จ๐ง ๐๐ง๐ ๐๐ง๐๐ฌ๐ญ๐จ๐ฆ๐จ๐ฌ๐ข๐ฌ. This means that the affected piece of intestine is removed (resection) and then intestine is sutured back together without that affected part (anastomosis). Generally these surgeries are reasonably successful, especially if there is no peritonitis.
๐๐ก๐จ๐ญ๐จ๐ฌ
1) A diagram showing the basic idea behind intussusception.
2) A cool ๐ฌ๐๐ ๐ข๐ญ๐ญ๐๐ฅ (lengthwise) section of an intussusception showing how the intestine has moved into the rest of the intestine.
3) A cross-section of an intussusception showing the layers in a different way. Do you see why it looks like a target on ultrasound?
4-6) Photos of different intussusceptions, including one from a Ferruginous hawk (Photo 6)!
๐๐จ๐ฎ๐ซ๐๐๐ฌ
Maxie, G. Jubb, Kennedy and Palmerโs Pathology of Domestic Animals, Volumes 2. Sixth Edition.
Photo 1 courtesy of Wikimedia Commons.
Photos 2-4 courtesy of Noahโs Arkive.
Photo 5-6 courtesy of University of Calgary Diagnostic Services Unit.
