9.20.21
Publication Date: 2021-09-19
History
7 year old german shepherd dog. 1-2 months of regurgitation and cough
6 images
Findings
Orthogonal radiographs of the thorax are available for interpretation.
The intrathoracic esophagus is diffusely, markedly distended with gas and homogeneous soft tissue opaque material/fluid. In addition to the soft tissue opaque contents, there is granular mineral opaque material in the rounded ventral outpouching of the esophagus, seen cranial to the cardiac silhouette. The cranial mediastinum is widened by the gas dilated esophagus on the VD view, and a mass in the cranial mediastinum is not identified.
There is a patchy unstructured interstitial to alveolar pattern throughout the ventral lung fields bilaterally.
The trachea deviates ventrally and rightward due to the distended esophagus.
The cardiovascular structures and remainder of the thoracic cavity are normal.
There is nominal T5-6 spondylosis deformans.
Diagnosis
The appearance of the mediastinum in the current study is most consistent with marked megaesophagus +/- an esophageal diverticulum, which may represent primary or secondary megaesophagus. A cranial mediastinal mass is not identified. The patchy pulmonary pattern may represent pneumonia secondary to chronic regurgitation/aspiration +/- fibrosis.
Discussion
The patient was discharged with medical treatment. Primary consideration is given to acquired idiopathic megaesophagus. Other etiologies have testing pending.
Notes
The case was initially seen by Dr. Lipe on the clinical floor.
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