Spontaneous gastric rupture presenting as severe pneumoperitoneum in a cat with presumed idiopathic gastric ulceration

Abstract

An 11-year-old female British blue cat was referred for investigation of acute onset vomiting and marked abdominal enlargement. Diagnostic investigations confirmed a large volume of free gas within the abdomen and changes highly suspicious of an ulcerative gastric lesion. Exploratory surgery confirmed the presence of a perforated gastric ulcer and histological analysis showed only associated inflammatory change. The ulcerated lesions were resected, and the cat recovered rapidly with complete resolution of clinical signs. Spontaneous gastric rupture due complete perforation of an ulcer is rarely reported in cats. The vast majority of reported cases present with septic peritonitis, and the majority are subsequently diagnosed with neoplastic disease or a chronic inflammatory aetiology. The cat reported here had no evidence of septic peritonitis, and the authors feel a final diagnosis of idiopathic gastric ulceration is most likely.

Tension pneumoperitoneum secondary to duodenal perforation presumptively due to the administration of meloxicam in a cat

“…4 SP and TP are most commonly the result of gastrointestinal perforation due to gastrointestinal neoplasia, inflammatory bowel disease, corticosteroids and NSAID administration. 3 In humans, perforation of the stomach or duodenum caused by peptic ulcer is considered the most common cause of the TP, and it has been reported as a complication of previous administration of NSAID and corticosteroids. 5 The incidence of gastrointestinal perforation secondary to NSAID or corticosteroid treatment has also been described in both cats and dogs.…”

“…Animals with SP had non-specific clinical signs such as lethargy, anorexia, vomiting and weight loss. 3,6 However, in the cases of TP, the intraabdominal free air reaches pressures high enough to impede venous return to the heart. This manifests as hypotension and decreased systemic perfusion.…”

“…2 It usually results from a perforation of the hollow viscus of the abdomen due to inflammatory bowel disease, neoplastic disease (lymphoma, adenocarcinoma and intestinal mast cell tumours), non-steroidal anti-inflammatory drugs (NSAIDs) and/or corticosteroids administration. 3 TP is a life-threatening form of pneumoperitoneum since there is a compromise of the cardiorespiratory function, and adequate management is important to save the patient's life. 1,2 The objective of this report is to describe a TP in a cat due to a duodenal perforation which was suspected to be secondary to the administration of NSAIDs.…”

“…Tension pneumoperitoneum (TP) is defined as the massive accumulation of intrabdominal air under pressure 2 . It usually results from a perforation of the hollow viscus of the abdomen due to inflammatory bowel disease, neoplastic disease (lymphoma, adenocarcinoma and intestinal mast cell tumours), non‐steroidal anti‐inflammatory drugs (NSAIDs) and/or corticosteroids administration 3 . TP is a life‐threatening form of pneumoperitoneum since there is a compromise of the cardiorespiratory function, and adequate management is important to save the patient's life 1,2…”

Potassium bromate cytotoxicity in the Wister rat model of chronic gastric ulcers: Possible reversal by protocatechuic acid

“…Despite the intricate array of protection for the stomach, the integrity of the gastric layers can be overwhelmed by factors known as gastric ulcerations that cause breaches to the mucosa (Gear et al, 1971;Glavin & Szabo, 1992). Gastric ulcers are characterized by a necrotic mucosa (Watanabe et al, 2004), inflammation (Adeniyi et al, 2007) and a distinct ulcer margin (Wan et al, 2018); They vary with sex and age (Cho et al, 2019); are largely idiopathic (Iijima et al, 2016;Mate et al, 2020); and can cause complications ranging from stomach perforations and hemorrhage to sepsis and death (Tarasconi et al, 2020).…”