GDV on radiographs: signs of gastric necrosis or perforation
8-year-old male German Shepherd Dog with unproductive retching and abdominal distension for 6 hours. After starting fluid therapy, a lateral abdominal radiograph is taken:
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Besides confirming GDV, which radiographic finding would suggest gastric necrosis or perforation?
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A. Compartmentalisation of the stomach by a soft-tissue band
It is the typical sign of volvulus (the fold separating the displaced pylorus from the gastric body), but it says nothing about the state of the wall.
B. Splenomegaly from congestion or twisting of the splenic vessels
It is common in GDV because the spleen is displaced with the stomach, and on its own does not indicate necrosis of the gastric wall.
C. Gas within the gastric wall, or free gas with loss of serosal detail
Correct. Intramural gas (pneumatosis) indicates loss of wall integrity and is usually associated with necrosis; free gas and loss of serosal detail suggest rupture and peritonitis. Both worsen the prognosis and anticipate a partial gastrectomy.
D. Gas-dilated oesophagus in the caudal thorax
It is a common finding in GDV, due to aerophagia and altered cardia function, and does not indicate necrosis of the gastric wall.
lightbulb Key takeaway
Radiography does not rule out gastric necrosis: the definitive assessment is made at surgery (colour, thickness and bleeding of the wall). A high lactate that does not fall with resuscitation is also associated with necrosis. Bear in mind that after trocarisation some iatrogenic free gas may be seen.
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Updated: October 31, 2026 · Educational content for veterinary professionals. It does not replace current clinical guidelines or the judgement of the attending veterinarian.