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Influence of repeat abdominal radiographs on the resolution of mechanical obstruction and gastrointestinal foreign material in dogs and cats.

Mechanical obstruction is a common cause of acute vomiting among small animals and radiography is the first line diagnostic tool. Due to many circumstances, surgery may not be an immediate treatment option. The purpose of this retrospective, cross-sectional design study is to determine the incidence of radiographic resolution of mechanical obstruction or gastrointestinal foreign material with medical management. Inclusion criteria included: clinical signs of vomiting, radiographic diagnosis of mechanical obstruction, suspect mechanical obstruction, foreign material suspected or definitively identified on the first set of radiographs and a second set of repeat radiographs within 36 h. Radiographic resolution was dependent on the location of dilation; 18/48 (37.5%) resolved were gastric, 6/35 (17.1%) were small intestinal, and 4/35 (11.4%) had concurrent gastric and small intestinal obstruction. Gastric dilation was more likely to resolve than SI dilation or both gastric and small intestinal dilation (P = .0119). Forty-nine animals without resolution went to surgery, with two developing pneumoperitoneum, and seven requiring intestinal resection, three of which had linear foreign bodies and three had intestinal masses/strictures. In conclusion, only 17.1% of animals with small intestinal dilation and a radiographic diagnosis of mechanical ileus resolved on repeat radiographs, and only 11.4% of animals with both small intestinal and gastric dilation resolved. Gastric dilation alone was more likely to resolve than small intestinal dilation or a combination of both. This may help to guide practitioners in recommendations for medical management of mechanical ileus in the future.