scholarly journals Non-iatrogenic traumatic isolated bilothorax in a cat

2017 ◽  
Vol 3 (1) ◽  
pp. 205511691771487
Author(s):  
Ronan A Mullins ◽  
Marc A Barandun ◽  
Barbara Gallagher ◽  
Laura C Cuddy
Keyword(s):  
Pleural Effusion ◽  
Gall Bladder ◽  
Peritoneal Fluid ◽  
Abdominal Ultrasound ◽  
Bile Peritonitis ◽  
Yellow Orange ◽  
Defect Repair ◽  
Bite Wounds ◽  
The Right ◽  
Diagnostic Investigations

Case summary A 6-month-old spayed female domestic shorthair cat presented for evaluation of suspected bite wounds over the right caudal thorax and left cranial flank. Thoracic radiographs identified a mild right-sided pneumothorax, a small volume of right-sided pleural effusion, with increased soft tissue opacity in the right cranial and middle lung lobes. Abdominal ultrasound identified a very small gall bladder and several small pockets of free peritoneal fluid. Cytological analysis of peritoneal fluid was consistent with a modified transudate. Following initial diagnostic investigations, yellow–orange fluid began to emanate from the right-sided thoracic wound. Biochemical analysis of this fluid was consistent with bile. Exploratory coeliotomy revealed a right-sided radial diaphragmatic tear, with herniation of the quadrate liver lobe and a portion of the gall bladder into the right pleural space. The gall bladder was bi-lobed and avulsion of a single herniated lobe resulted in leakage of bile into the right pleural cavity, without concurrent bile peritonitis (biloabdomen). The cat underwent total cholecystectomy and diaphragmatic defect repair and recovered uneventfully. Relevance and novel information To our knowledge, at the time of writing non-iatrogenic isolated bilothorax without concurrent biloabdomen has not been previously reported in the cat. This case highlights the importance of thorough assessment of cats with seemingly innocuous thoracic bite wounds. Despite the rarity of its occurrence, bilothorax should be considered a differential in cats with pleural effusion, even in the absence of bile peritonitis. We believe that the optimal treatment of cases of bilothorax is multifactorial and should be determined on a case-by-case basis.

Pleural effusion as a complication of extrahepatic biliary tract rupture in a dog

1996 ◽  
Vol 32 (5) ◽  
pp. 409-412 ◽  
Author(s):  
MD Barnhart ◽  
LM Rasmussen
Keyword(s):  
Pleural Effusion ◽  
Supportive Care ◽  
Biliary Tract ◽  
Peritoneal Fluid ◽  
Pleural Space ◽  
Traumatic Rupture ◽  
Bile Peritonitis ◽  
Fluid Accumulation

Bile pleural effusion associated with traumatic rupture of the extrahepatic biliary tract and bile peritonitis in a dog is described. Pleural and abdominal fluids were identical cytologically and chemically despite a grossly intact diaphragm. Transfer of peritoneal fluid across the diaphragm via lymphatics and subsequent leakage into the pleural space is the likely cause of effusion. Pleural and abdominal fluid accumulation resolved spontaneously with repeated abdominocenteses and supportive care.

scholarly journals Spontaneous cholecystopleural fistula leading to biliothorax and sepsis in a cat

2019 ◽  
Vol 5 (1) ◽  
pp. 205511691983020
Author(s):  
Gretchen M VanDeventer ◽  
Benoît Y Cuq
Keyword(s):  
Pleural Effusion ◽  
Gall Bladder ◽  
Biochemical Analysis ◽  
Gall Bladder Disease ◽  
Abdominal Ultrasound ◽  
Tubular Structure ◽  
Fistula Formation ◽  
Gastrointestinal Lymphoma ◽  
Bladder Disease ◽  
Case Summary

Case summary A 13-year-old spayed female domestic shorthair cat presented with pleural effusion and suspected triaditis. Intake vitals and leukocytosis were consistent with a diagnosis of systemic inflammatory response syndrome. Biochemical analysis confirmed a pleural fluid-to-serum bile ratio consistent with a diagnosis of biliothorax. Abdominal ultrasound failed to identify a definitive gall bladder but noted a hypoechoic tubular structure ventral to the liver and contacting the diaphragm. Thoracic ultrasound identified a hyperechoic structure contacting the diaphragm at the same location. Thoracoabdominal CT scan identified a fluid-dense tubular structure extending from ventral to the liver, through a diaphragmatic defect and directly communicating with the pleural space, suspected to be an abnormal gall bladder. The cat was humanely euthanized, and post-mortem analysis confirmed a cholecystopleural fistula arising from the gall bladder with multifocal abscesses, mixed inflammatory hepatic infiltrates and small-cell gastrointestinal lymphoma. Culture of the abscess isolated Parabacteroides merdae, meeting the reported feline criteria for sepsis. Relevance and novel information To our knowledge, spontaneous cholecystopleural fistula formation leading to biliothorax and sepsis has not been previously reported in the cat. This case highlights a novel sequela of gall bladder disease in this species, and biliothorax should be a differential diagnosis for pleural effusion in cats with evidence of cholecystitis or triaditis.

scholarly journals P046 Pointing the finger: an unusual presentation of dactylitis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Natalia Cernovschi - Feasey ◽  
Julekha Wajed
Keyword(s):  
Pleural Effusion ◽  
Soft Tissue ◽  
Middle Finger ◽  
Joint Involvement ◽  
Long Bones ◽  
History Of ◽  
Systemic Symptoms ◽  
The Right ◽  
Hands And Feet ◽  
Radiographic Changes

Abstract Background/Aims  Dactylitis is commonly associated with psoriatic arthritis, and regularly presents at Rheumatology clinics. We discuss a case where progressive systemic symptoms lead to the consideration of alternate diagnoses. Methods  A 46-year-old Nepalese woman presented to the Rheumatology department with a 3 month history of diffuse swelling of the right middle finger proximal interphalangeal joint, with the appearance of dactylitis. There was pain on movement, but no other joint involvement. Simultaneously she noticed blurred and decreased vision, which on review by the ophthalmologists, was diagnosed with bilateral uveitis. There was no history of psoriasis, inflammatory bowel disease, or other past medical history of note. There was no travel history in the past 12 months. A diagnosis of a presumed inflammatory arthritis was made. Results  Blood tests showed elevated c-reactive protein 55 (normal <4 mg/l), erythrocyte sedimentation rate 138 (normal 0-22 mm/hr) and an iron deficiency anaemia. Rheumatoid factor and Anti-CCP antibody were negative. Hand radiographs were reported as normal. MRI of the third digit confirmed an enhancing soft tissue collection at the proximal phalanx of the right middle finger. She was referred for a biopsy of this lesion. Interestingly over the subsequent few months, she developed progressive breathlessness. Chest radiograph showed a left pleural effusion. Further tests showed negative serum ACE, Lyme and Toxoplasma screen. Quantiferon test was negative. Pleural aspirate showed a transudate with negative Acid-fast bacillus (AFB) test and culture. CT chest and abdomen showed a persistent pleural effusion, inflammatory changes in the small bowel and thickening of the peritoneum and omentum. In view of the systemic involvement, a peritoneal tissue biopsy was performed. This confirmed chronic granulomatous inflammation with positive AFB stain for mycobacterium tuberculosis. Our patient was started on quadruple anti- TB antibiotics for 6 months. Her systemic symptoms and dactylitis have improved, although there is on-going treatment for her ocular involvement. Conclusion  Approximately 10% of all cases of extrapulmonary TB have osteoarticular involvement. Dactylitis is a variant of tuberculous osteomyelitis affecting the long bones of the hands and feet. It occurs mainly in young children; however adults may be affected also. The first manifestation is usually painless swelling of the diaphysis of the affected bone followed by trophic changes in the skin. The radiographic changes are known as spina ventosa, because of the ballooned out appearance of the bone, although this was not seen in our case. Fibrous dysplasia, congenital syphilis, sarcoidosis and sickle cell anaemia may induce similar radiographic changes in the metaphysis of long bones of hands and feet, but do not cause soft tissue swelling or periosteal reaction. This case highlights the importance of testing for TB, especially in atypical cases of dactylitis, with other systemic features. Disclosure  N. Cernovschi - Feasey: None. J. Wajed: None.

Complicated EBV infection in a healthy child

2021 ◽  
Vol 14 (3) ◽  
pp. e241099
Author(s):  
Hugo Teles ◽  
Teresa Brito ◽  
Joana Cachão ◽  
Susana Parente
Keyword(s):  
Healthy Child ◽  
Acalculous Cholecystitis ◽  
Abdominal Ultrasound ◽  
Good Prognosis ◽  
Left Ventricular ◽  
Acute Acalculous Cholecystitis ◽  
Cervical Lymph Nodes ◽  
Barr Virus ◽  
Ebv Infection ◽  
The Right

The Epstein-Barr virus (EBV) is highly prevalent throughout the population. Although in most cases, the infection has a good prognosis, it can cause severe complications. We report a case of a healthy child with a primary EBV infection that evolved with two rare complications. She first presented in the emergency room with fever and sore throat, and was diagnosed with tonsillitis and medicated with antibiotic. She returned 7 days later for fatigue, vomiting and abdominal pain. The examination revealed tonsillitis, swollen cervical lymph nodes and pain in the right hypochondrium. An abdominal ultrasound was performed, compatible with acute acalculous cholecystitis. She was admitted in the paediatric nursery and medicated with intravenous antibiotics. The EBV serology revealed primary infection. Two days later, she developed cardiogenic shock and had to be transferred to an intensive care unit under mechanical ventilation and inotropics. She was discharged 12 days later, keeping a moderate left ventricular dysfunction.

scholarly journals A Case with Severe Endometriosis, Ovarian Hyperstimulation Syndrome, and Isolated Unilateral Pleural Effusion after IVF

2017 ◽  
Vol 2017 ◽  
pp. 1-4
Author(s):  
Negjyp Sopa ◽  
Elisabeth Clare Larsen ◽  
Anders Nyboe Andersen
Keyword(s):  
Pleural Effusion ◽  
Ovarian Hyperstimulation Syndrome ◽  
Common Finding ◽  
Ovarian Hyperstimulation ◽  
Pleural Effusions ◽  
Luteal Support ◽  
Vitro Fertilization ◽  
Fluid Production ◽  
The Right

We present a very rare case of right-sided isolated pleural effusion in a patient with severe endometriosis who, in relation to in vitro fertilization (IVF), developed ovarian hyperstimulation syndrome (OHSS). Earlier laparotomy showed grade IV endometriosis including endometriotic implants of the diaphragm. The patient had no known risk factors for OHSS and only a moderate number of oocytes aspirated. She received, however, repeated hCG injections for luteal support. The patient did not achieve pregnancy but was hospitalized due to pain in the right side of the chest and dyspnoea. A chest computed tomography (CT) showed a pleural effusion on the right side. Total of 1000 ml of pleural fluid was drained after a single thoracentesis. After three days, the symptoms and fluid production ceased. Ascites is a common finding in OHSS, but pleural effusions are rare. Further, isolated pleural effusions have not previously been described in a patient with endometriosis. We suggest that the repeated hCG injections induced effusions from the endometriotic lesions at the diaphragm and as a consequence this patient developed isolated hydrothorax.

scholarly journals Transient Hydroureteronephrosis Caused by a Foley's Catheter Tip in the Right Ureter

2005 ◽  
Vol 5 ◽  
pp. 367-369 ◽  
Author(s):  
Jacob George ◽  
George Tharion
Keyword(s):  
Teaching Hospital ◽  
Tertiary Care ◽  
Abdominal Ultrasound ◽  
Physical Medicine ◽  
Urethral Catheterization ◽  
Ureteric Orifice ◽  
Unilateral Hydronephrosis ◽  
Catheter Tip ◽  
Foley’S Catheter ◽  
The Right

We report a case of unilateral hydronephrosis following urethral catheterization in a patient with T6 complete paraplegia at the Physical Medicine and Rehabilitation Department in a tertiary care teaching hospital, India. Diagnosis was established by an abdominal ultrasound. The misplaced catheter tip was withdrawn from the ureteric orifice and hydronephrosis was resolved. Foley's catheterization, a widely practiced clinical procedure, is not without its attendant risks of an inadvertent placement in the ureter leading to transient hydronephrosis. Inadequate drainage through a catheter should thus alert one to this potentially hazardous complication that can be diagnosed by an early ultrasound. This complication can be avoided by gently tugging on the catheter after inflating the catheter bulb.

scholarly journals ANALISIS PEMERIKSAAN LABORATORIUM PADA KASUS LEPTOSPIROSIS DISERTAI ABSES HATI AMOEBA

2021 ◽  
Vol 3 (3) ◽  
pp. 131-139
Author(s):  
Donaliazarti Donaliazarti
Keyword(s):  
Liver Abscess ◽  
Clinical Manifestations ◽  
Abdominal Ultrasound ◽  
Amoebic Liver Abscess ◽  
Personal Hygiene ◽  
Serological Examination ◽  
Mild Anemia ◽  
Prolonged Aptt ◽  
The Right ◽  
Time Of Admission

Leptospirosis is a disease caused by spirochaeta microorganism of the genus Leptospira, while the amoebic liver abscess is an extraintestinal complication by Entamoeba Histolytica. Both diseases occurred in a 45-year-old man with poor personal hygiene and environment sanitation. Amoebic liver abscess was found to be a coincidence that was thought to have existed before the patient developed leptospirosis so that the two diseases caused overlapping clinical manifestations in the patient, but the acute symptoms experienced by the patient at the time of admission were more likely to be caused by his leptospirosis. Patient complained of high fever, yellowing of the skin and eyes, urinating like concentrated tea, stiffness in both legs, nausea, vomiting and heartburn. On physical examination found febrile, tachycardia, icteric on skin and sclera, ciliary injection, and hepatomegaly. Laboratory tests showed mild anemia with normocytic normochromic features, leukocytosis with neutrophilia shift to the right, thrombocytosis, increased ESR, prolonged APTT, hyperbilirubinemia, elevated SGOT SGPT, ALP and GGT enzymes, hypoalbuminemia, hyperglobulinemia, and bilirubinuria. Microscopic examination with negative staining of urine samples found Leptospira. Abdominal ultrasound examination showed a solitary space occupying lesion (SOL) in the right lobe of the liver and on serological examination showed positive antiamoeba. Based on the above, this patient was diagnosed as having coincident leptospirosis with amoebic liver abscess.

scholarly journals Ultrasound with laparoscopy for the diagnosis of abdominal disorders in cattle

2021 ◽  
Vol 41 ◽  
Author(s):  
José Ricardo B. Silva ◽  
José Augusto B. Afonso ◽  
Carla L. Mendonça ◽  
Jobson Filipe P. Cajueiro ◽  
Juliana M. Alonso ◽  
...  
Keyword(s):  
Clinical Study ◽  
Clinical Laboratory ◽  
Abdominal Ultrasound ◽  
Accurate Diagnosis ◽  
Prospective Clinical Study ◽  
Focal Lesions ◽  
Diagnosis And Prognosis ◽  
Complete Blood Counts ◽  
The Right ◽  
Exploratory Laparoscopy

ABSTRACT: This study aimed to evaluate laparoscopy with abdominal ultrasound exams to establish accurate diagnosis and prognosis. The experimental design was a prospective clinical study. Nine adult crossbred bovines suffering from abdominal disorders were admitted to the cattle clinic for clinical examinations. Abdominal ultrasound was carried out, and complete blood counts were performed. Subsequently, exploratory laparoscopy was performed. After surgery (exploratory laparoscopy on the right or left side), animals with a severe prognosis or untreatable clinical condition were euthanised and necropsied. During laparoscopy, circumscribed reticuloperitonitis could not be detected, nor could other abnormalities in the cranioventral region of the abdomen previously observed on ultrasound and confirmed during necropsy. However, alterations due to peritoneal damage, such as adhesions, were observed dorsally in addition to alterations in macroscopic aspects of the peritoneal fluid. Exploratory standing laparoscopy through the paralumbar fossae may constitute a supplementary procedure for diagnosing abdominal disorders in cattle, but it is not suitable in cases of diseases characterised by focal lesions concentrated in the cranioventral region of the abdomen. When associated with clinical, laboratory, and ultrasound examinations, this technique may improve the accurate diagnosis and prognosis of abdominal disorders in cattle.

scholarly journals Hermafroditismo verdadeiro na espécie canina

2017 ◽  
Vol 45 ◽  
pp. 5
Author(s):  
Paula Priscila Correia Costa ◽  
Cleyson Teófilo Braga Filho ◽  
Luana Azevedo Freitas ◽  
Maressa Holanda Dos Santos ◽  
Leonardo Alves Rodrigues Cabral ◽  
...  
Keyword(s):  
Complete Blood Count ◽  
Body Condition Score ◽  
External Genitalia ◽  
Abdominal Ultrasound ◽  
General Term ◽  
Lower Quadrant ◽  
True Hermaphrodite ◽  
Genital Ambiguity ◽  
The Right ◽  
Umbilical Scar

Background: Hermaphroditism or intersex is a general term that includes various congenital anomalies of the genital system which is used to define animals with ambiguous sexual characteristics. It occurs in domestic animals, more commonly in pigs and goats, and rarely in horses, dogs, sheep, and cattle. The prevalence of hermaphroditism varies a lot among breeds and species and is higher in groups with a high degree of consanguinity. Therefore, the objective of this report is to describe a case of canine hermaphroditism in a dog with male phenotype, as well as the anatomical and hormonal findings, and classification of the hermaphroditism exhibited by the animal studied.Case: A 1-year-old, mongrel, 5 kg dog was referred to the UHV-UECE due to the presence of a slit on the lower quadrant of the abdomen, caudal to the umbilical scar. At examination, the animal exhibited normal rectal temperature, no alterations of palpable lymph nodes, and a satisfactory body condition score. The pubic area had 2 testicles, each one in a different scrotum, 1 to the right and 1 to the left of the slit. A prepuce with no apparent function was present cranially to the slit, closer to the umbilical scar. At the other extremity of the slit, on the pubic region, there was a flaccid structure similar to a penis (micropenis) with no penile bone and no function. The slit was open until the area ventral to the anus, where the urethra was detected. The animal exhibited a behavior of territory demarcation with urine typically seen in male dogs. Orchiectomy and slit correction surgery were performed. Pre-surgical exams included: complete blood count and hormonal doses of estradiol, testosterone, and progesterone. Abdominal ultrasound was performed to assess presence of sexual glands and gonads. The hormonal exam revealed: estradiol 56.39 pg/mL; testosterone 127.9 ng/mL; progesterone 0.892 ng/mL. A uterus was not detected on ultrasound examination. Ovaries were seen on their typical anatomical position; they were symmetrical and had normal sizes. There was a normal size prostate in the pelvic area, exhibiting normal texture and echogenicity. No other abnormalities were seen and the owner opted for no further surgical intervention.Discussion: Testosterone predominance explains the male behavior and appearance, demonstrating that the testis were prevalent over the ovaries. The occurrence of XX males has been reported. The genetic cause is the absence of the SRY chromosome, which has a fundamental role on activation of the SOX gene, which is responsible for sex determination. Clinically, a true hermaphrodite can exhibit different degrees of genital ambiguity; they can be diagnosed during puberty with the emergence of heterosexual characteristics, or as an adult, with infertility or gonadal neoplasia. True hermaphrodites are individuals with testicular and ovarian tissues, either combined in one gonad (ovotestis) or present as two separate gonads. The presence of ovaries and testicles can be confirmed by histology, which was not performed in this study. However, ultrasound findings (prostate and ovaries), and the presence of normal testis and external genitalia without a defined penis or vulva are in accordance with the description of a true hermaphrodite.

scholarly journals A hematologic condition expressed as a lung disease

F1000Research ◽  
2012 ◽  
Vol 1 ◽  
pp. 28 ◽  
Author(s):  
Mónica Egozcue-Dionisi ◽  
José Nieves-Nieves ◽  
Ricardo Fernández-Gonzalez ◽  
Rosángela Fernández-Medero ◽  
Raúl Reyes-Sosa ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Pleural Effusion ◽  
Plasma Cells ◽  
Rare Complication ◽  
Disease Stage ◽  
Fluid Analysis ◽  
Progressive Dyspnea ◽  
Breath Sounds ◽  
The Right ◽  
Pleural Involvement

Pleural involvement secondary to Multiple Myeloma is considered a very rare complication. According to the literature only 1% of these patients develop a myelomatous pleural effusion. We present a case of a 39 year old man with multiple myeloma diagnosed six years prior to our evaluation, which developed progressive dyspnea, dry cough and right pleuritic chest pain two weeks prior to admission. On physical examination the patient had decreased breath sounds over the right posterior hemithorax accompanied by dullness to percussion. The chest radiogram was consistent with a right sided pleural effusion. Pleural fluid analysis revealed the presence of abundant abnormal plasma cells. The patient died four weeks after hospitalization. The presence of myelomatous pleural effusion is considered to be a poor prognostic finding, no matter at what disease stage it develops. So far no definite treatment has been shown to improve survival.

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