RADIOGRAPHIC DIAGNOSIS

ELIZABETH WATSON, DVM

Signalment Five-month-old, male Doberman Pinscher.

History and Physical Examination The dog was referred to the Veterinary Teaching Hospi-

tal of the University of Florida because of depression and dyspnea persisting for five days. A thoracocentesis had been performed one day before presentation, and 150 mil- liliters of serosanguinous fluid were removed. Lung sounds were diminished and breathing was labored.

Radiography

graphs were made (Fig. 1).

Radiographic Findings Multiple pleural margins were visible in the ventral one

half of the thoracic cavity on the lateral projections. A large

Dorsoventral and left and right lateral thoracic radio-

This report submitted by Elizabeth Watson, DVM, Crispin P. Spencer, DVM, Norman Ackerman, DVM, Joseph Taboada, DVM, PhD, Box 5-102, JHMHC, Departments of Medical Sciences and Radiology, Col- lege of Veterinary Medicine, University of Florida, Gainesville, FL 32610.

Published as the College of Veterinary Medicine, University of Florida, Journal Series No. 164.

Address correspondence and reprint requests tg Elizabeth Watson, DVM, Box 5-102, JHMHC, Departments of Medical Sciences and Radiology, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610.

Received: December 22,1987. Accepted for publication: June 27,1988.

radiolucent area without vascular shadows was present in the left hemithorax. A fluid-filled interlobar fissure was visible in the right hemithorax. A linear soft-tissue opacity extended from the thoracic inlet to the dorsal aspect of the left crus of the diaphragm (Fig. 2).

Discussion Pneumothorax and hydrothorax were identified on the

thoracic radiographs. The left lung lobes were collapsed, producing a soft-tissue dense mass which obscured the cardiac shadow. A foreign body was identified in the left pleural cavity on the right and left lateral and dorsoventral radiographs.

Pneumothorax may be due to various causes. Sources of air include penetration from the external body surface; rupture of a lung, bronchus, pulmonary bulla, subpleural bleb, or cavitary lesion; perforation of the esophagus or trachea; or perforation of the gastrointestinal tract and diaphragm with concurrent pneumoperitoneum. In this dog, an external wound at the site of entry for the foreign body was not seen, Because free mediastinal air was not visible, perforation of the esophagus or trachea was less likely. Although inhaled foreign bodies can penetrate bronchial structures and cause pneumothorax, the large size of the linear foreign body in this patient precluded inhalation. Although gastric and diaphragmatic penetra- tion was considered most likely, no abnormality was detected on abdominal radiographs.

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VOL. 30, No. 6 RADIOGRAPHIC DIAGNOSIS 285

FIG. 1 . Right lateral (A), left lateral (B), and dorsoventral (C) thoracic radiographs of a dog with a history of depression and dyspnea of five days’ duration.

286 RADIOGRAPHIC DIAGNOSIS 1989

FIG. 2. A foreign body is visible in the left pleural cavity (arrows). The foreign body is better seen in the right lateral view because it is surrounded by a large volume of pleural gas. Distorted pleural margins are seen in the ventral thorax on the lateral views.

VOL. 30. No. 6 RADIOGRAPHIC DIAGNOSIS 287

Final Diagnosis

A left-sided thoracotomy was performed and a 16- centimeter long stick was removed from the left pleural cavity (Fig. 3). A fistula was traced from the pleural space through the diaphragm and into the stomach. The stomach was adhered to the left diaphragmatic crus, suggesting that the stick had been swallowed, had punctured the stomach wall and diaphragm, and then had become lodged in the pleural cavity. The pneumothorax resolved within four days after Of the foreign body* The dog has had no other problems after surgery.

FIG. 3. The foreign body, a 16-centimeter long stick, was removed from the left pleural cavity.

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May 7-8, 1990: written examination for previously approved candidates. Completed applications, fees, and supporting material must be received no later than July 1, 1989 for those seeking first-time and reexamination. 1990 oral portion of the examination is to be held between November 1 and December 15. Applications for reexamination of the oral portion must be received by January 31, 1990. Examination objectives, additional information, and application forms are available from Dr. M. Bernstein, Executive Secretary, American College of Veterinary Radiology, P.O. Box 87, Glencoe, IL 60022.