Case of the week 12.26.22

University of Tennessee

veterinary.radiology.mirc@gmail.com

Publication Date: 2022-12-26

History

1 year old australian cattle dog. Attacked/kicked by a horse about 90 min ago

6 images

Orthogonal radiographs of the abdomen and pelvis are available for interpretation.

The serosal detail and retroperitoneal detail are mildly diminished and there are fluid opaque streaks throughout the plane of the abdomen.

There is a focal discontinuity of the caudoventral abdominal wall. The portions of the abdominal wall immediately adjacent to the defect are thickened. A long portion of the small intestinal tract has herniated through the wall defect into the inguinal region.

The small intestinal tract (both intra-abdominal and herniated portions) contains a minimal amount of gas and fluid/homogeneously soft tissue opaque material without evidence of focal distension/obstruction. The margins of several of the herniated intestinal segments are poorly defined due to a region of increased soft tissue opacity in the hernia, which likely represents fluid.

The urinary bladder is not identified.

The liver is generally large, but considered normal for the age of the patient. The discernible portions of the spleen and kidneys are normal.

There are multiple pelvic fractures of the pubis and left ischium, involving at least the left pubic ramus, pubic symphysis, and left ischiatic table. A small bone fragment is noted ventral to the caudal aspect of the ischia in the lateral views. The left sacroiliac joint is luxated. The left side of the pelvis is displaced cranially.

All the thoracic pathologies are described in last week case of the week :-)

• Loss of peritoneal and retroperitoneal detail is suspected to indicate hemorrhage. Uroabdomen from ureteral or urinary bladder rupture are not excluded.

• Multiple pelvic fractures (left pubis and ischium) with left sacroiliac luxation resulting in cranial displacement of the left aspect of the pelvis

• Large abdominal wall rent with herniation of small intestinal segments into the inguinal region. A small volume of hemorrhage is suspected in the inguinal hernia. There is no radiographic evidence of intestinal obstruction. Intestinal ischemia/strangulation is not ruled out.

Lack of identification of the urinary bladder may indicate an intrapelvic location and/or a small size from recent urination. Urinary bladder rupture is not ruled out.

This case was initially seen by Dr. Stokowski