Case of the week 1.6.19
Publication Date: 2020-01-06
History
5 year old female spayed ShiTzu, fell off the stairs a few days ago. Not doing well. Swelling on the ventral aspect of the chest.
2 images
Findings
Orthogonal radiographs of the thorax are available for interpretation. Collimation on the lateral view could be improved.
On the ventral aspect of the sternum, extending on the lateral projection from cranioventral to caudodorsal, there is a well defined linear metallic structure, in the shape of a sewing needle. There is moderate soft tissue swelling ventral to the sternum. The distal end of the sewing needle is superimposed with the pulmonary parenchyma and cardiac silhouette on both views.
There is no evidence of pneumothorax.
The pulmonary parenchyma and cardiac silhouette are considered to be within normal limits. Multiple small pulmonary osteomas are noted.
There is good serosal detail in the abdomen. A moderate amount of ingesta is noted within the lumen of the stomach.
Diagnosis
Sewing needle at the level of the ventral sternum. Based on radiographs it's unclear if the needle penetrated the thoracic cavity. However, there is no evidence of pneumothorax, pleural effusion or other secondary sign. Additional imaging is recommended such as ultrasound or CT.
Discussion
Under ultrasound guidance the needle was located and retrieved. The needle was mostly embedded in the subcutaneous fat. No complications ensued. The patient was discharged with antibiotherapy.
It is likely that the dog fell on the needle while falling of the stairs.
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