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

Abstract

A 4‐year‐old neutered domestic cat was presented with a history of vomiting, anorexia, lethargy and severe abdominal distension. The cat was hypothermic and hypotensive. It had received a week course of meloxicam. Abdominal radiographies revealed the presence of a very large volume of peritoneal gas associated loss in peritoneal serosal detail and gastric dilatation. The presumptive diagnosis was tension pneumoperitoneum and peritonitis caused, most likely, by a gastrointestinal perforation. Exploratory laparotomy confirmed the presence of a duodenum perforation. At the end of the surgery, the cat suffered a cardiorespiratory arrest and died. Unfortunately, the post‐mortem examination was not allowed. Spontaneous pneumoperitoneum is a rare condition reported in cats. The incidence of non‐steroidal anti‐inflammatory drugs (NSAIDs) induced by gastroduodenal perforation in cats has been reported in a few cases. In the cat reported here, the authors suspect that duodenal perforation was secondary to NSAID administration.

Case report: Radiography and computed tomography of tension pneumoperitoneum caused by gastric perforation in a dog

“…To date, three veterinary cases of TPP have been reported. Of them, one case was experimentally induced in a dog, whereas the remaining two occurred in cats and were caused by perforations in the stomach and duodenum ( 4 , 5 , 7 ). Although the number of cases is small, the present and previous cases indicate that GI perforation may be the primary cause of TPP in veterinary medicine, similar to that in humans.…”

“…Tension pneumoperitoneum (TPP) is a type of pneumoperitoneum characterized by the excessive accumulation of gas in the peritoneal cavity, leading to cardiorespiratory distress (1)(2)(3)(4)(5). Excessive gas within the peritoneal cavity increases intraabdominal pressure and pushes the diaphragm cranially, leading to respiratory distress accompanied by tachypnea (1,2).…”