Case of the week 9.5.23
Publication Date: 2023-09-05
5 images
Findings
Study: Opposite lateral and ventrodorsal projections of the abdomen are available for review.
Findings: The peritoneal serosal detail is mildly, diffusely decreased. There are large, soft tissue, tubular structures within the left and right caudal to mid-abdomen.
The liver extends mildly beyond the costal arch, but maintains sharp caudoventral margins. The spleen is normal in size and margins. The visualized margins of the kidneys are normal. The urinary bladder appears to be empty and the margins are unable to be visualized.
The stomach contains a moderate volume of gas and soft tissue opacity. The duodenum is gas filled on the left lateral and ventrodorsal views, though the pyloroduodenal angle appears normal. The rest of the small intestine is homogeneously fluid opaque and normal in size and course. The large intestine contains a small amount of unformed fluid admixed with gas.
The included caudal thorax and diaphragm are within normal limits. The musculoskeletal structures are normal.
Diagnosis
The large, tubular soft tissue structures in the mid to caudal abdomen are consistent with a pyometra. A hydrometra or mucometra are considered less likely considering the clinical signs. 2. Gas filling of the duodenum may be incidental/transient but has anecdotally been described with pancreatitis. 3. The loss of the peritoneal detail could be due to visceral crowding or a small volume of peritoneal effusion.
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