Download Radiology Packet 14 - University of Prince Edward Island

Radiology Packet 14
Thorax-Trauma
3 yr old male DSH cat
• HX = presentation of severe respiratory distress, missing
for 2 days, open mouth breathing and cyanotic mucous
membranes on PE, lack of lung sounds bilaterally in
caudal thorax on auscultation
3 yr old male DSH cat
3 yr old male DSH cat
•
RF
– In the VD view the heart is shifted cranially and to the left.
– In the VD view there is increased lung opacity in the mid R hemithorax.
– Large rounded and bilobed lucent structure seen in the caudal thorax
(gas dilated stomach).
•
RD
– Diaphragmatic hernia
•
Next
– Surgery
1 yr old MC Golden Retriever
“Max”
• HX = presented 6 hrs after being hit by car, initially
seemed fine to owners but 2 hours after accident
increased respiratory difficulty was noted
1 yr old MC Golden Retriever
“Max”
1 yr old MC Golden Retriever
“Max”
•
RF
–
–
–
–
In the lateral view there is separation of the heart from the sternum.
A triangular soft-tissue structure is seen caudally, just ventral to the aorta.
In the VD view the left hemi-thorax appears exceptionally lucent.
Three structures with roughly triangular shape and soft tissue opacity are visible
to the left of the heart (totally collapsed lung lobes).
– Retraction of the right caudal lung lobe from the thoracic wall is present.
– Cardiac shift (mediastinal shift) to the right.
•
RD
– Bilateral pneumothorax
– Tension pneumothorax (L sided)
•
Next
– Place chest tube, monitor
5 yr old female Golden Retriever
“Bella”
• HX = hit by car
5 yr old female Golden Retriever
“Bella”
5 yr old female Golden Retriever
“Bella”
•
RF
– On the lateral view there are bizarre gas streaks over the thorax, shoulder,
sternum and cranial mediastinum.
– There is visualization of the outer wall of the trachea, esophagus, and
brachiocephalic artery, separation of the heart from the sternum, and retraction of
the caudal lung lobes.
– On the VD view there is subcutaneous gas along the left thoracic wall, increased
opacity of the cranial mediastinum, cardiac shift to the left, left 5-7 rib fractures.
– Also, lobar borders are seen between the right middle and caudal lung lobes as
well as heavy pulmonary infiltrates throughout all the lungs.
•
RD
–
–
–
–
•
Pneumomediastinum/thorax
Subcutaneous emphysema
Pulmonary contusions
Rib fractures
Next
– Supportive care
13 yr old male Pekingese
“Benjamin”
• Hx = presented for
routine vaccines and a
dentistry, on
auscultation the heart
sounds are muffled
13 yr old male Pekingese
“Benjamin”
•
•
•
RF
– Silhouetting of the cardiac and diaphragmatic shadows are noted, esp in
the right caudal region.
– Radiolucent tubular structures were seen, especially cranial and left of
the heart.
RD
– Peritoneal-pericardial diaphragmatic hernia
– Traumatic diaphragmatic hernia
Next
– Surgery is an option if the hernia causes clinical signs, currently the dog
is not experiencing any.
5 yr old male Golden Retriever
“Dune”
• HX = Presented in
respiratory distress
and limping on right
hind limb, owners
report he escaped
for 3 hours and
believe he may
have been hit by a
car
5 yr old male Golden Retriever
“Dune”
5 yr old male Golden Retriever
“Dune”
•
RF
–
–
–
–
–
–
•
RD
–
•
Increased opacity of the lung tissue cranioventral to the heart, air bronchograms are visible.
Minor retraction of the left lung lobes from the thoracic wall by the presence of a small
amount of gas.
A small band of gas is seen surrounding the cardiac silhouette on the right side.
On the lateral view the heart is separated from the sternum and there is a focal area of
lucency between the cardiac apex and sternum.
Fractures are present of the left 1st through 5th ribs.
A faint pleural fissure line is present at the 7th rib on the right indicating a small amount of
free pleural fluid.
Pulmonary contusion, mild pneumothorax, multiple rib fractures, subcutaneous edema of the
axillary region
Next
–
Supportive care
9 yr old FS Cocker Spaniel
“Sarah”
• HX = hit by car on
10/12 and presented
for evaluation of
labored breathing on
10/31
9 yr old FS Cocker Spaniel
“Sarah”
9 yr old FS Cocker Spaniel
“Sarah”
•
•
•
RF
– Cannot evaluate the cardiac silhouette or diaphragmatic margin due to
increased soft tissue opacity within the pleural cavity.
– Cardiac silhouette in shifted to the left.
– Multiple tubular gas-filled structures are visible in the left half of the
thoracic cavity.
– A metallic projectile is visible in the cranial abdominal cavity.
RD
– Right-sided traumatic diaphragmatic hernia
Next
– Surgery to repair the hernia