Caudal esophageal twist sign may help in differentiating between 360° gastric dilatation-volvulus and gastric dilatation in dogs.

Abstract

Objective: To identify radiographic features of dogs with 360° gastric dilatation volvulus (GDV) distinguishable from those associated with GD.

Methods: A multi-institutional medical record review was performed for cases of canine 360° GDV between April 2008 and September 2022. Gastric dilatation cases were retrieved from a single academic institution.

Results: Radiographs of 29 client-owned dogs surgically diagnosed with 360° GDV and 38 dogs with GD were included. The most common radiographic findings in dogs with a 360° GDV included the gastric fundus located caudoventrally (lateral; 100%), the pyloric antrum located craniodorsally (lateral; 88%), an abnormally shaped and sized spleen (36%), and decreased peritoneal detail (81%). When marked esophageal gas dilatation was present, a funnel shape to the caudal esophagus (ie, "caudal esophageal twist sign") was appreciable in all dogs presenting with volvulus. However, orogastric decompression prior to radiographs resulted in mild to no esophageal gas dilatation, hindering radiographic identification of this sign. In dogs with GD, the gastric fundus was in the craniodorsal position (lateral) and left cranial abdomen (ventrodorsal or dorsoventral) in 100% of cases. The pyloric antrum was in the right cranial abdomen (ventrodorsal or dorsoventral views) in 100%. The spleen and peritoneal detail were normal in all dogs with GD.

Conclusions: The funnel-shaped caudal esophagus (caudal esophageal twist sign) was compatible with 360° GDV in dogs with moderate or severe esophageal gas dilatation and was absent in dogs with GD.

Clinical relevance: This new radiographic feature of 360° GDV may help practitioners distinguish between 360° GDV and GD.