Getting to the GUT of the problem

2D74743F163FAD0040275EFBB237BB24There can be many causes of a sore tummy.

Forest presented with a sore tummy and vomiting. Xrays showed us that he had something in his stomach that was not budging. After 24 hours in hospital and just before we were about to perform surgery to remove the foreign body, Forest vomited up a clothing tag attached to some cotton and a partly digested chicken bone. To confirm that we were not dealing with more of a linear foreign body we went into surgery and removed more of the cotton and string to ensure he would be ok.

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Forest however did not improve to 100%. He was just a bit off. He ate copious amounts of grass and would once every 2-3 days vomit up grass, bile and occasionally food. So we decided 6 weeks later to perform an endoscopy as radiographs failed to highlight any obvious foreign body. Endoscopy revealed a serious case of Inflammatory Bowel Disease (IBD). Forests Duodenum was covered in a purulent (pus) discharge. His stomach, although better than his Duodeum, showed evidence of inflammatory disease. For your information (and I apologise if it is a little over your head) I have placed his results below. It demonstrates how good the results can be from an endoscopic (key hole) procedure.

At the time of the original surgery I took a stomach sample and was able do histopathology on that. I was also able to see how the disease has progressed when Forest was in acute disease to when it was chronic and long term.

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Diagnosis
  1. Full thickness gastric biopsy from 13/4/2011:  Patchy mucosal and submucosal hemorrhage with congestion, diffuse mild lamina proprial edema, focal glandular necrosis and active  gastritis with occasional eosinophils,
  2. Gastric endoscopic biopsies from 9/6/2011.  Moderate mucosal edema, congestion and mild fibrosis with mild to moderate chronic-active gastritis, mild Helicobacter species infection and mild glandular atrophy.
  3. Duodenum 9/6/2011.  Moderate chronic-active suppurative and eosinophilic enteritis with villous congestion,

The good news is that Forest is now on a locally active steroid and is almost back to normal within 3 weeks of commencing the medication.

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