Decortication, thoracic omentalization, and pericardiectomy for treatment of severe fibrosing pleuritis in a cat

2022 ◽  
pp. 1-6
Author(s):  
Danny Sack ◽  
Philip Hyndman ◽  
Melissa Milligan ◽  
Daniel Spector
Keyword(s):  
Pleural Effusion ◽  
Surgical Management ◽  
Multimodal Analgesia ◽  
Clinical Findings ◽  
Acute Onset ◽  
Thoracic Wall ◽  
Thoracic Radiography ◽  
Pulmonary Atelectasis ◽  
Clinically Normal ◽  
Lung Lobes

Abstract CASE DESCRIPTION A 5-year-old spayed female domestic shorthair cat was evaluated because of an acute onset of dyspnea and open-mouthed breathing. CLINICAL FINDINGS Thoracic radiography revealed pleural effusion and signs consistent with restrictive pleuritis, and results of preoperative CT were consistent with diffuse, severe restrictive pleuritis, bilateral pleural effusion, and pulmonary atelectasis. Thoracocentesis yielded a red, turbid fluid that was identified as chylous effusion with chronic inflammation. TREATMENT AND OUTCOME Exploratory thoracotomy revealed diffuse, severe fibrous adhesions between the mediastinum, heart, lung lobes, and thoracic wall, with a thick fibrous capsule enveloping all lung lobes. Surgical treatment consisted of complete pleural decortication, pericardiectomy, and thoracic omentalization. The cat remained hospitalized for 6 days, receiving oxygen supplementation, multimodal analgesia, and supportive care. Long-term home care consisted of prednisolone administration, rutin supplementation, and provision of a low-fat diet. At recheck examinations 3-, 7-, and 20-weeks postoperatively, the cat remained tachypneic, but was otherwise clinically normal without dyspnea or respiratory distress. Follow-up thoracic radiography revealed improved pulmonary expansion, decreased pleural effusion, and resolved pneumothorax. CLINICAL RELEVANCE Surgical management of fibrosing pleuritis secondary to idiopathic chylothorax in cats has historically resulted in poor outcomes. This report details the first successful use of complete decortication in the surgical management of severe fibrosing pleuritis in a cat.

scholarly journals Convolutional Neural Network-Processed MRI Images in the Diagnosis of Plastic Bronchitis in Children

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Xiaoqun Chen ◽  
Rong Lu ◽  
Feng Zhao
Keyword(s):  
Pleural Effusion ◽  
Pulmonary Inflammation ◽  
Appearance Model ◽  
Jaccard Coefficient ◽  
Plastic Bronchitis ◽  
Pulmonary Atelectasis ◽  
Lung Lobe ◽  
Segmentation Accuracy ◽  
Magnetic Resonance Imaging Mri ◽  
Lung Lobes

Objective. The study focused on the features of the convolutional neural networks- (CNN-) processed magnetic resonance imaging (MRI) images for plastic bronchitis (PB) in children. Methods. 30 PB children were selected as subjects, including 19 boys and 11 girls. They all received the MRI examination for the chest. Then, a CNN-based algorithm was constructed and compared with Active Appearance Model (AAM) algorithm for segmentation effects of MRI images in 30 PB children, factoring into occurring simultaneously than (OST), Dice, and Jaccard coefficient. Results. The maximum Dice coefficient of CNN algorithm reached 0.946, while that of active AAM was 0.843, and the Jaccard coefficient of CNN algorithm was also higher (0.894 vs. 0.758, P < 0.05 ). The MRI images showed pulmonary inflammation in all subjects. Of 30 patients, 14 (46.66%) had complicated pulmonary atelectasis, 9 (30%) had the complicated pleural effusion, 3 (10%) had pneumothorax, 2 (6.67%) had complicated mediastinal emphysema, and 2 (6.67%) had complicated pneumopericardium. Also, of 30 patients, 19 (63.33%) had lung consolidation and atelectasis in a single lung lobe and 11 (36.67%) in both two lung lobes. Conclusion. The algorithm based on CNN can significantly improve the segmentation accuracy of MRI images for plastic bronchitis in children. The pleural effusion was a dangerous factor for the occurrence and development of PB.

scholarly journals Pleural effusions in the dog. Etiology, Pathogenesis, Diagnosis and Treatment

2018 ◽  
Vol 51 (4) ◽  
pp. 262
Author(s):  
S. Ε. KLADAKIS (Σ.Ε. ΚΛΑΔΑΚΗΣ) ◽  
K. K. ADAMAMA - MORAITOU (Κ. Κ. ΑΔΑΜΑΜΑ-ΜΩΡΑΪΤΟΥ) ◽  
T. S. RALLIS (Τ.Σ. ΡΑΛΛΗΣ)
Keyword(s):  
Pleural Effusion ◽  
Conservative Therapy ◽  
Clinical Findings ◽  
Tube Placement ◽  
Thoracic Radiography ◽  
Severe Respiratory Distress ◽  
Pericardial Disease ◽  
Heartworm Disease ◽  
The Everyday ◽  
Electrolyte Replacement

Accumulation of fluid (pleural effusion) in the pleural space of dogs is a relatively common clinical entity in the everyday practice. These can result from variable causes, such as right-sided heart failure, pericardial disease, hypoalbouminemia, neoplasia, heartworm disease, diaphragmatic hernia, bleeding disorders, traumatic or idiopathic causes. Diagnosis is based on history, clinical findings, laboratory tests, thoracocentesis, thoracic radiography and/or ultrasonography. Therapeutic approach depends on the etiology and the clinical condition of the affected dog. In dogs presented with severe respiratory distress, and after the confirmation of pleural effusion with thoracic radiography, thoracocentesis is performed to stabilize the animal's condition. If indicated, surgical management is attempted. Conservative therapy includes intravenous fluid and electrolyte replacement, antibiotics administration and chest tube placement in refractory cases. Moreover, pleurodesis may be indicated in chronic relapsing cases.

scholarly journals Emphysematous lesions in the right cranial lung lobe and torsion of the right medial lung lobe in a British shorthair cat: a case report

2017 ◽  
Vol 60 (No. 12) ◽  
pp. 706-711 ◽  
Author(s):  
Z. Dokic ◽  
W. Pirog
Keyword(s):  
Histopathological Examination ◽  
Serum Biochemistry ◽  
Postoperative Recovery ◽  
Clinical Findings ◽  
Acute Onset ◽  
Middle Lobe ◽  
Venous Flow ◽  
Lung Lobe ◽  
The Right ◽  
Lung Lobes

A three-year-old male British shorthair cat that had exhibited progressive lethargy and intermittent dyspnoea for 14 days was referred for evaluation of acute respiratory deterioration. Clinical findings included rapid and shallow breathing, pale mucous membranes, sound suppression on the right side, and a subcutaneous haematoma in the right epigastric area. Serum biochemistry analysis showed leukocytosis and thrombocytosis. Radiographs revealed hydropneumothorax, a broken eighth right rib, atelectatic right cranial lung lobe (RCrL), and consolidation of the right middle lobe (RML). Doppler examination revealed sonographic changes in the echotexture of both lobes and venous flow was absent in the twisted RML. Furthermore, bronchoscopy showed proximal narrowing of the cat’s RML bronchus. Exploratory surgery via medial sternotomy confirmed torsion of the RML and identified deteriorated gas-containing lesions in the collapsed RCrL. Both lung lobes were removed by standard lobectomy, and postoperative recovery was without major complications. Histopathological examination diagnosed multiple bullae and blebs, with significant subpleural haemorrhages in the atelectatic RCrL, whereas tissue congestion with haemorrhages, necrosis, and thrombosis typical for lung lobe torsion were observed in the RML. No other underlying aetiology was apparent. Two months post-operatively, the cat presented with similar acute onset of dyspnoea and spontaneous pneumothorax and was euthanised at the owner’s request. The autopsy revealed identical new emphysematous changes in the contra-lateral lung lobes that had been absent at the time of surgery. Emphysematous lesions, regardless of their origin, should be considered in the etiopathology of lung lobe torsion.  

scholarly journals Typical and atypical CT chest imaging findings of novel coronavirus 19 (COVID-19) in correlation with clinical data: impact on the need to ICU admission, ventilation and mortality

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Doaa M. Emara ◽  
Nagy N. Naguib ◽  
M. A. Moustafa ◽  
Salma M. Ali ◽  
Amr Magdi El Abd
Keyword(s):  
Pleural Effusion ◽  
Complete Recovery ◽  
Clinical Findings ◽  
Mediastinal Lymphadenopathy ◽  
Imaging Features ◽  
Imaging Findings ◽  
Icu Admission ◽  
Mortality Outcome ◽  
Novel Coronavirus ◽  
Contrast Ct

Abstract Background The aim of this study was to highlight the typical and atypical chest CT imaging features at first presentation in 120 patients who were proved to be COVID-19 by PCR and to correlate these findings with the need for ICU admission, ventilation, and mortality. We retrospectively included 120 patients 71 males (59.2%) and 49 females (40.8%) with a mean age of 47.2 ± 14.4 years. Patients subjected to clinical assessment, CBC, PCR for COVID-19, and non-contrast CT chest at first presentation. Typical and atypical imaging findings were reported and correlated with the clinical findings of the patients, the need for ICU admission, ventilation, and mortality. Results Clinically, fever was seen in 112 patients followed by dry cough in 108 patients and malaise in 35 patients. The final outcome was complete recovery in 113 cases and death in 7 cases. Typical CT findings included bilateral peripheral ground-glass opacities (GGO) in 74.7%, multilobar affection in 92.5% while atypical findings such as homogeneous consolidation, pleural effusion, mediastinal lymphadenopathy, and single lobar affection were found in 13.4, 5, 6.7, and 7.5% respectively. A statistically significant association between the presence of white lung, pleural effusion, peripheral GGO, and the need for ICU admission as well as mechanical ventilation was noted. The death was significantly higher among elderly patients; however, no significance was found between the imaging features and mortality. Conclusion CT features at first presentation can predict the need for ICU admission and the need for ventilation but cannot predict the mortality outcome of the patients.

Chlamydial Pneumonia in Infants

1986 ◽  
Vol 8 (5) ◽  
pp. 132-152
Keyword(s):  
Pleural Effusion ◽  
Clinical Findings ◽  
Radiographic Findings ◽  
Long Duration ◽  
Eosinophil Counts

In 1977, Beem and Saxon (N Engl J Med 1977; 296: 306) reported on a new infant pneumonia syndrome caused by Chlamydia. Subsequently, it was noted that these infants with pneumonia were usually less than 6 months of age. When patients with chlamydial pneumonia were compared with infants with pneumonia of other etiologies, patients with chlamydial pneumonia had a syndrome characterized by long duration (more than 1 week), symptoms of cough and congestion, absence of fever, a staccatotype cough, rales, elevated eosinophil counts, and elevated immunoglobulins. Radiographic findings were not specific for chlamydial pneumonia but were very suggestive when they occurred in an infant with the classical clinical findings. In such patients, findings included bilateral hyperexpansion and diffuse infiltrates (interstitial or nodular). In addition, areas of atelectasis and coalescence were often seen, but pleural effusion and lobar consolidation were not.

scholarly journals The relation of the pleural thickening in tuberculosis pleurisy with the activity of adenosine deaminase

2005 ◽  
Vol 63 (2) ◽  
Author(s):  
B. Uskul ◽  
H. Turker ◽  
C. Ulman ◽  
M. Ertugrul ◽  
A. Selvi ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Clinical Findings ◽  
X Rays ◽  
Biochemical Tests ◽  
Pleural Thickening ◽  
Group I ◽  
Immunological Mechanisms ◽  
Tuberculosis Pleurisy

Selvi, A. Kant, S. Arslan, M. Ozgel. Background: Residual pleural thickening (RPT) still occurs in most patients with tuberculosis pleurisy despite advances in the treatment of tuberculosis. The aim of this study was to evaluate the significance of RPT in tuberculosis pleurisy with the patients clinical findings, biochemical and microbiological properties of pleural effusion and with the total adenosine deaminase (ADA) and isoenzymes levels. Methods: 121 tuberculosis pleurisy patients were evaluated retrospectively. According to posteroanterior chest x-rays, the 63 (52%) cases with the thickness 2 mm or more in lower lateral hemithorax were grouped as I and the 58 (48%) cases without pleural thickness were grouped as II. The amount of pleural effusion was classified into small, medium or massive according to their chest x-rays. In both groups; sex, age, symptoms score, bacteriological and biochemical tests and ADA levels were recorded. Results: 81 (67%) male and 40 (33%) female, overall 121 patients were enrolled into the study. RPT was found higher in males (p=0.014) and the increase ran parallel with the amount of cigarette smoking (p=0.014). RPT was found to be lower in small effusions (p=0.001). The group with RPT, the serum albumin was found lower (p=0.002), pleural fluid total protein (p=0.047) and the ratio of pleural fluid protein to serum protein (p=0.002) were found higher. In group I, total ADA: 69.5±38.9 IU/L and ADA2: 41.3±31.6 IU/L were higher than the cases without RPT (p=0.032, p=0.017, respectively). Conclusions: We suggest that the immunological mechanisms are effective in the development of pleural thickening.

scholarly journals Management of Benign Middle Ear Tumors: A Series of 7 Cases

2017 ◽  
Vol 96 (10-11) ◽  
pp. 426-432
Author(s):  
Z. Jason Qian ◽  
Amy M. Coffey ◽  
Kathleen M. O'Toole ◽  
Anil K. Lalwani
Keyword(s):  
Surgical Management ◽  
Middle Ear ◽  
Ossicular Chain ◽  
Clinical Findings ◽  
Mastoid Cavity ◽  
Canal Wall ◽  
Tumor Excision ◽  
Canal Wall Down ◽  
Canal Wall Down Mastoidectomy ◽  
Rare Group

Benign middle ear tumors represent a rare group of neoplasms that vary widely in their pathology, anatomy, and clinical findings. These factors have made it difficult to establish guidelines for the resection of such tumors. Here we present 7 unique cases of these rare and diverse tumors and draw from our experience to recommend optimal surgical management. Based on our experience, a postauricular incision is necessary in nearly all cases. Mastoidectomy is required for tumors that extend into the mastoid cavity. Whenever exposure or hemostasis is believed to be inadequate with simple mastoidectomy, canal-wall-down mastoidectomy should be performed. Finally, disarticulation of the ossicular chain greatly facilitates tumor excision and should be performed early in the procedure.

Visualization of the inferoposterior thoracic wall (VIP) and boomerang signs-novel sonographic signs of right pleural effusion

2018 ◽  
Vol 36 (7) ◽  
pp. 1134-1138 ◽  
Author(s):  
James Siu Ki Lau ◽  
Chi Kit Yuen ◽  
Ka Leung Mok ◽  
Wing Wa Yan ◽  
Pui Gay Kan
Keyword(s):  
Pleural Effusion ◽  
Thoracic Wall

Calcinosis circumscripta of the thoracic wall in a German shepherd dog

1998 ◽  
Vol 34 (2) ◽  
pp. 153-156 ◽  
Author(s):  
EB Davidson ◽  
KS Schulz ◽  
ER Wisner ◽  
JA Schwartz
Keyword(s):  
Patent Ductus Arteriosus ◽  
Complete Resolution ◽  
Ductus Arteriosus ◽  
Surgical Excision ◽  
Thoracic Wall ◽  
German Shepherd ◽  
Thoracic Radiography ◽  
German Shepherd Dog ◽  
Surgical Manipulation ◽  
Patent Ductus

Calcinosis circumscripta of the left thoracic wall was diagnosed in a six-month-old, female German shepherd dog by thoracic radiography and ultrasonographic-guided biopsy. The puppy developed the lesion following a left thoracotomy to repair a patent ductus arteriosus. Complete resolution occurred following surgical excision of the lesion. Calcinosis circumscripta associated with routine surgical manipulation and postoperative inflammation has been reported rarely but should be suspected when a focal, mineralized lesion occurs at a previous surgical site, especially in German shepherd dogs.

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