Case of the week 2.20.23
Publication Date: 2023-02-20
History
7 year old male castrated husky. Respiratory distress.
4 images
Findings
Thorax - ventrodorsal and opposite lateral radiographs are available for review.
A chest tube is in place, entering the thorax at the left 8th intercostal space and coursing axially and cranially, terminating at the level of the third ribs. There is a small volume of gas in the pleural space, most pronounced on the left with retraction of the lung lobes from the body wall.
There is a mild to moderate unstructured interstitial pulmonary pattern in the caudal subsegment of the left cranial lung lobe and left caudal lung lobe, with a focal region of alveolar pulmonary pattern in the left caudal lung lobe.
There is a moderate leftward mediastinal shift of the cardiac silhouette. The cardiovascular structures are otherwise normal. The esophagus contains a small volume of gas cranially and ill-defined fluid opaque material caudally.
There is a small gas bubble superimposed with the falciform fat ventral to the liver on the right lateral projection.
The musculoskeletal structures included in collimation are normal.
Diagnosis
- Left-sided chest tube in place.
- The multifocal pulmonary pattern is most likely attributed to atelectasis. Underlying pulmonary abnormality can not be completely ruled out. A cause for the pneumothorax is not identified.
- Aerophagia and caudal esophageal fluid (consider transient swallowing or gastroesophageal reflux).
- Equivocal pneumoperitoneum versus superimposition of subcutaneous gas.
Discussion
A CT was performed to rule out underlying causes of pneumothorax and was mostly unremarkable.
Notes
This case was initially seen by Dr Griffith on clinics.
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