What’s up in the antrum?

gastroduodenal intussusception

I think it is pyloric intussusception

I mean pylorogastric

Severe gastric dilatation with fluid content, secondary to pyloric occlusion. At this level we can see a luminal structure formed by mucosa/submucosa layer of the gastric wall, with white radial stripe.
My first diagnosis is pyloric polypoid hyperplasia and related gastric occlusion/sub-occlusion

Pyloric stenosis. They are wonderful images!!!!

The pyloric antrum is really thick, especially the muscularis. This breed is prone to chronic hypertrophic pyloric gastropathy. However, it appears there is a pyloroduodenal intussusception.

I think antrum is hypertrophic, however It seems there is a pyloroduodenal intussusception and I wouldn´t rule out a foreign body near the pylorus.

The appearance of the antrum is very abnormal with what appears to be the ‘ring sign’ that results when there is an intussusception, which in this case would be the duodenum into the pyloric antrum. The wall of the antrum is very thickened and edematous which often happens to the intussuscipiens or the outer segment.

It looks like pyloroduodenal intussusception, possibly chronic? as antrum is thickened?

The radiographs are of adequate diagnostic quality though the collimation is tight and may have excluded areas of concern. There are multiple abnormal vertebrae in the thoracic and thoracolumbar areas and these should be assessed further with ventrodorsal radiography views and a full neurological assessment.
There is poor abdominal contrast on both views which could be due to low levels of intra-abdominal fat, peritoneal fluid or generalised inflammation - this should be assessed further.
In the right lateral radiography, there is a large, roughly spherical soft tissue opacity in the ventral midabdominal area and the gas of the fundus of the stomach is directed in a ventro-caudal direction towards the soft tissue opacity suggesting that the later may be related to the stomach.
The left lateral radiograph shows some ingesta and gas within the small intestines, with a gas filled viscus visible in the ventral abdomen at the costal arch.

Sonographically, the image quality is excellent though concentrates entirely on the stomach so the rest of the abdomen is not visible. There is no peritoneal fluid visible in the cine loop attached but fluid may be visible in more ventral views of the abdomen. The mesentery and fat around the stomach is of normal echogenicity.
The cine loop shows a very dilated fundus of the stomach with homogenous, gently swirling fluid ingesta and normal wall layering and assessed normal thickness. The cardia is not visible in the video. The pylorus of the stomach is also dilated with the wall assessed to be a little thickened (no callipers available) with the contents of multilayered small intestine with radiating hyperechoic lines within the mucosal layer of the trapped small intestine. This represents a duodenal-pyloric intussception and the hyperechoic radiating lines are likely to be distended lacteals in the entrapped duodenum.
Small sections of pancreas, liver and spleen are also visible in the video and appear normal but the video does not cover the entirety of these organs.

The recommendation is that this dog goes to surgery to have the intussception corrected. This patient is at high risk of reflux under general anaesthetic and therefore careful management is required such as keeping the head raised during induction and securing the airway and placing a stomach tube and emptying the stomach contents.

Stenotic pylorus, muscularis is hypertrophic, circumferential mucosal hyperplasia and polyp, possible intussusception.
RX : abnormal shape of the pyloric bubble on L, hemivertebrae
Thank you for the case !!

Ultrasound: Hyperplasic polyp in antro/pylorus with gastric mecanic obstrucción (maybe parcial)
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very interesting. thank you for sharing

Duodeno-pyloric intussusception