scholarly journals Diagnostic imaging of migrating kebab (sosatie) sticks – a review of 8 cases

2011 ◽  
Vol 82 (3) ◽  
Author(s):  
N. Stander ◽  
R. M. Kirberger
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Diagnostic Imaging ◽  
Clinical Signs ◽  
Patient Survey ◽  
Clinical Syndrome ◽  
Small Animals ◽  
Secondary Complications ◽  
Younger Age ◽  
Variable Duration

Complications related to extraluminal migration of ingested kebab (sosatie) sticks are infrequently diagnosed in small animals. A total of 8 cases diagnosed with extragastric migration of ingested kebab sticks were retrospectively evaluated. No significant breed or sex predilection was found but there was a tendency for animals to present at a younger age (less than 3 years). Clinical signs (of variable duration) were non-specific and included haemoptysis, abdominal pain, regurgitation, subcutaneous abscessation and chronic draining sinus tracts, making a clinical diagnosis difficult. Ultrasonography proved invaluable in facilitating the diagnosis of kebab stick migration in 6 of the cases and computed tomography unexpectedly identified a kebab stick that had migrated into the thorax in 1 patient. Survey radiography was generally found to be insensitive in identifying the kebab sticks. The aim of this article is to alert veterinarians to a clinical syndrome that may not be considered a differential diagnosis in patients with non-specific inflammatory disease of the thorax, abdomen or pelvic regions and to illustrate the usefulness of the various diagnostic imaging modalities in facilitating a diagnosis of kebab stick ingestion and its possible secondary complications.

scholarly journals Surgical treatment of a thoracic oesophageal duplication cyst causing recurrent dysphagia in an adult dog

2018 ◽  
Vol 63 (No. 4) ◽  
pp. 175-180
Author(s):  
A. Foglia ◽  
S. Del Magno ◽  
M. Pietra ◽  
V. Cola ◽  
M. Joechler ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Surgical Treatment ◽  
Physical Examination ◽  
Clinical Signs ◽  
Duplication Cyst ◽  
Intact Male ◽  
Normal Limits ◽  
Oesophageal Duplication Cyst

A 7-year-old intact male Rottweiler dog was evaluated for recurrent dysphagia and regurgitation. Physical examination was unremarkable and routine blood works were within normal limits. Computed tomography revealed a defined lesion in the caudal mediastinum arising from the oesophagus. The lesion was excised using intercostal thoracotomy and the histological diagnosis was oesophageal duplication cyst. The dog recovered uneventfully and at a 3-year follow-up no clinical signs were reported. Although extremely rare, oesophageal duplication cysts should be considered in the differential diagnosis in cases of chronic regurgitation and dysphagia associated with evidence of an oesophageal lesion.

scholarly journals DIAGNOSTICS OF INFLAMMATORY INSIDE THE PLEURAL COMPLICATIONS OF THORACIC INJURY

2018 ◽  
Keyword(s):  
Computed Tomography ◽  
Clinical Signs ◽  
Pathological Process ◽  
Spiral Computed Tomography ◽  
Diagnostic Methods ◽  
Thoracic Wall ◽  
Thoracic Injury ◽  
Spiral Computed ◽  
Secondary Complications ◽  
X Ray

The non-specificity of the clinical signs of posttraumatic purulent thoracic complications indicates the importance of instrumental diagnostic methods. There is no generally accepted algorithm for examining an injured person with a chest injury that would allow timely recognition of purulent complications in the posttraumatic period. The results of the examination of patients with intra-pleural complications of thoracic injury using the spiral computed tomography method, which in dynamics allows objectively documenting the dynamics of the pathological process, evaluating the effectiveness of treatment, timely diagnose secondary complications, are presented. Тhe analysis of the results of the study indicates the need for a comprehensive examination of suspected post-traumatic intra pleural thoracic complications. In the presence of any manifestations of systemic inflammatory response in the posttraumatic period in patients with chest lesions, regardless of the results of the X-ray examination, ultrasound examination and computed tomography of the chest should be performed, which allows to detect the accumulation of pathological contents in the pleural and pericardial cavity, to assess the nature changes in the pulmonary tissue, mediastinum, thoracic wall and decide on the drainage of lesions fester. At the same time, for the correct interpretation of some changes in spiral computed tomography, including the lung abscess that developed in the background of pulmonary hemorrhages and mediastinitis against the background of hemorrhages in the mediastinum and pneumomediastinum, it is necessary to compare them with the baseline data. This testifies to the necessity of performing an early spiral computed tomographic examination in patients with chest lesions in the presence of any focal changes on the review X-ray. Spiral computer tomography of the chest in dynamics allows to objectively document the dynamics of the pathological process, evaluate the effectiveness of treatment, timely diagnose secondary complications. The application of this algorithm allows to diagnose the entire spectrum of intra-pleural complications in the early stages and to avoid diagnostic errors.

scholarly journals Megaesophagus Secondary to Feline Dysautonomia (Key-Gaskell Syndrome) in a Cat

2016 ◽  
Vol 44 (1) ◽  
pp. 4
Author(s):  
Gabriela Da Cruz Schaefer ◽  
Daniel Guimarães Gerardi ◽  
Neusa Barbosa Castro ◽  
Lorena Lima Barbosa Guimarães ◽  
Luciana Sonne ◽  
...  
Keyword(s):  
Differential Diagnosis ◽  
Diagnostic Imaging ◽  
Autonomic Neuropathy ◽  
Aspiration Pneumonia ◽  
Chest Radiography ◽  
Keratoconjunctivitis Sicca ◽  
Clinical Signs ◽  
The United States ◽  
Histopathological Analysis ◽  
Nasal Discharge

Background: Feline dysautonomia is a rare autonomic neuropathy of unknown cause, that has already been reported in Europe, the United States and Brazil. Cats usually show nonspecifc clinical signs that are associated with autonomic dysfunction of the nervous system. The diagnosis is based on the clinical signs and imaging tests, and confrmed by necropsy and histopathological fndings. The prognosis is poor and there is no defnitive treatment. The aim of this report is to describe a case of feline dysautonomia with emphasis in the clinical, diagnostic imaging and histopathological fndings. Feline dysautonomia must always be considered as a differential diagnosis in cases of megaesophagus in cats.Case: A mixed-breed young male cat was evaluated for anorexia, regurgitation, bilateral nasal discharge and dyspnoea for 24 h. The animal was dehydrated and had pale mucous membranes, abdominal distension and keratoconjunctivitis sicca. The neurological examination was normal. Abdominal ultrasound showed a distended bladder and normal intestinal motility. Chest radiography and esophageal contrast study exhibited megaesophagus in the intrathoracic region. Blood work showed mild neutrophilic leukocytosis and the presence of toxic neutrophils. The cat remained hospitalized for supportive care, including fluidtherapy, broad spectrum antibiotics, antiemetic and mucosal protective drugs. Twelve days after the admission, the cat presented prostration, hypoglycemia, hypothermia, hypokalemia and severe leukopenia. Chest radiography revealed increased radiopacity in the right hemithorax, suggesting aspiration pneumonia. The cat died and during necropsy there was marked megaesophagus, with areas of erosion/ulceration of the mucosa, in addition to pulmonary consolidation areas. The histopathological analysis showed an extensive area of ulceration in the esophageal epithelium, in addition to infltration of lymphocytes, macrophages and occasional neutrophils and numerous bacteria, compatible with ulcerative esophagitis. The lung analysis showed severe multifocal thrombosis, multifocal areas of athelectasia, moderate congestion and edema, vegetable material in the bronchi, basophilic myriad bacterial and multifocal necrosis. Hypereosinophilic neurons with pyknotic nuclei, mild cytoplasmic vacuolization, loss of granular appearance of Nissl substance and nuclei shifted to the periphery were observed in the esophageal ganglia. The post mortem diagnosis was megaesophagus and chronic active esophagitis with neuronal degeneration, confrming the diagnosis of feline dysautonomia and aspiration pneumonia.Discussion: This cat was presented with nonspecifc clinical signs, megaesophagus, constipation, keratoconjunctivitis sicca and regurgitation that are commonly observed in cases of feline dysautonomia. However, there were also expiratory dyspnoea, which is less common. Unlike most cases, this cat did not show mydriasis, prolapsed nictitating membranes, reduced pupillary light response or bradycardia. Considering the evolution of its clinical condition, it was suspected that the cat died due to sepsis, possibly as a result of aspiration pneumonia. Since feline dysautonomia is uncommon and requires histopathological analysis for diagnosis confrmation, the prevalence of the disease might be underestimated in our region. In this case, the clinical evaluation, diagnostic imaging, macroscopic and histopathological fndings were consistent with dysautonomia, therefore it is important to consider the disease as a differential diagnosis in cases of megaesophagus in cats, even in the absence of other classical signs of autonomic dysfunction.Keywords: ganglioneuropathy, autonomic neuropathy, neurology, cat.

Partial Gastric Obstruction Caused by Cajarana (Spondias cytherea Sonn) in Puppies - Imaging Techniques for Diagnosis

2018 ◽  
Vol 46 ◽  
pp. 4
Author(s):  
Maisa Oliveira De Freitas ◽  
Carmen Vládia Soares De Sousa ◽  
Francisco Felipe De Guimarães ◽  
João Marcelo Azevedo de Paula Antunes ◽  
Gislayne Cristianne Xavier Peixoto
Keyword(s):  
Gastrointestinal Tract ◽  
Foreign Body ◽  
Diagnostic Imaging ◽  
Barium Sulfate ◽  
Foreign Bodies ◽  
Clinical Signs ◽  
Small Animals ◽  
Moderate Degree ◽  
Pyloric Region ◽  
Gastric Obstruction

Background: Ingestion of foreign bodies is one of the most common cases seen among puppies of dogs in the medical clinics of small animals which may be related to their curious behavior. The diagnosis is based on the patient’s history, clinical signs, and complementary diagnostic imaging tests. The present case report describes the use of complementary imaging tests, showing a partial gastric obstruction caused by cajarana (Spondias cytherea Sonn) in a puppy.Case: At the Veterinary Hospital of the Federal Rural University of the Semi-Arid Region, a 4-month-old male Yorkshire dog was treated. The guardian reported having witnessed the ingestion of a cajarana stone by the animal. During the physical examination, the animal was active, with good nutritional status, normocorated mucosae, and a moderate degree of dehydration, besides a slight pain on palpation in the epigastric region. Hematological examinations included blood counts, blood urea, creatinine, and alkaline phosphatase. A moderate degree of polycythemia was observed, which may be explained by the dehydration caused by the episodes of vomiting. The patient had frequent episodes of vomiting after the reported event and was then referred to the diagnostic imaging sector. During the sonographic examination, a concave echogenic interface associated with a posterior acoustic shadowing was observed in the region of the stomach. The animal was sent for simple radiographs and positive contrast based on barium sulfate due to the suspicion of the presence of a foreign body. On simple radiography, in the left laterolateral view, a little radiopaque structure of circular format with poor definition was observed in the pyloric region. After the simple radiography, approximately 10 mL of barium sulfate contrast was administered orally followed by a new left lateral radiographic imaging. On performing sequenced radiographs, a discrete barium contrast contour, oval in structure, located in the pyloric region was observed, even after gastric emptying for about 1 h, reinforcing the clinical suspicion of cajarana stone ingestion. In view of these results, the animal underwent a gastrostomy for the removal of cajarana, which measured about 2.5 cm in diameter. After the surgical procedure, the animal had a good clinical recovery.Discussion: The history of the animal along with clinical signs and imaging tests are of great assistance in the investigation of gastric foreign bodies. The most common type of foreign bodies found in the gastrointestinal tract of small animals are bones, but other atypical structures may also be found, as shown in this report. Radiography (simple and with contrast) is an imaging method widely used in veterinary medicine because of its low cost and clinical accessibility. It is important for the investigation of gastrointestinal obstructions, being of fundamental importance in the management of this case. Ultrasound examination also provides crucial information when foreign bodies are suspected since the formation of intense posterior acoustic shadow (described in this case) is one of the characteristic findings of this condition. Finally, the associated radiography and ultrasonography as diagnostic imaging for the investigation of foreign bodies in the gastrointestinal tract complement each other. Depending on the nature of the foreign body, a single imaging examination may not be satisfactory to suggest the presence of a foreign body with certainty.

Abstract T P43: Hyperdense Basilar Artery (HDBA) Sign: Its Association With Clinical Signs, Symptoms And Outcome Of Posterior Circulation Ischemic Stroke

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
Fritzie R Ugdamina ◽  
Mabel M Macas ◽  
Vijay K Aggarwal ◽  
Herminigildo H Gan
Keyword(s):  
Computed Tomography ◽  
Ischemic Stroke ◽  
Ct Scan ◽  
Basilar Artery ◽  
Predictive Value ◽  
Clinical Signs ◽  
Clinical Syndrome ◽  
Posterior Circulation ◽  
Conventional Angiography ◽  
Cranial Ct

Background and purpose: Posterior circulation ischemic stroke is a clinical syndrome associated with ischemia related to stenosis, in situ thrombosis, or embolic occlusion of the posterior circulation arteries - the vertebral arteries, basilar, posterior cerebral arteries, and their branches. In order to reach the definite diagnosis, different imaging methods can be used, such as CT (computed tomography) and MRI (magnetic resonance imaging), or by conventional angiography. Hyperdense Basilar artery (HDBA) is a radiologic sign seen on unenhanced computed tomography scan suggestive of an early ischemic stroke. In a hospital facility that lacks advancement in neuroimaging, evaluating HDBA sign on unenhanced cranial CT scan can help clinicians in the diagnosis of posterior circulation ischemic stroke. Methods: A total of 67 subjects were included in the study. Medical records and neuroimaging of patients with a final diagnosis of posterior circulation ischemic stroke were retrieved. The radiologist who read the Cranial CT Scan was blinded as to the clinical signs, symptoms, and outcome of our subjects. All neuroimaging were reviewed as to location of the posterior circulation infarction, and for presence or absence of HDBA sign. Results: There were higher proportions with cerebellar signs and quadriplegia among those with positive HDBA sign, and a higher proportion with ocular signs among those with negative HDBA sign. However, we found no significant statistical difference (P=0.185). Location of infarction (P=0.363), baseline NIHSS (p=0.307), MRS on discharge (P=0.938), and timing of neuroimaging (P=0.227) were also not statistically significant. A positive HDBA sign had low sensitivity (54%), specificity (43%) and positive predictive value (16%). However, it had a high negative predictive value which means that among those found without an HDBA sign, 83% are likely to survive. Conclusion: There is no significant association between HDBA sign and clinical findings among patients with a posterior circulation ischemic stroke. Among those found with a positive HDBA sign, there is high likelihood for the presence of infarction and for those with a negative HDBA sign, a higher likelihood for survival.

COVID-19: how nuclear medicine can provide a differential diagnosis in very dubious case

Coronaviruses ◽  
2020 ◽  
Vol 01 ◽  
Author(s):  
Maria Silvia De Feo ◽  
Viviana Frantellizzi ◽  
Giuseppe De Vincentis
Keyword(s):  
Infectious Disease ◽  
Differential Diagnosis ◽  
Ct Scan ◽  
Imaging Technique ◽  
False Negative ◽  
Clinical Signs ◽  
Negative Results ◽  
Infectious Disease Department ◽  
False Negative Results ◽  
99Mtc Hmpao

Background: We present the case of a 55-year-old woman, admitted to the Infectious Disease Department of Policlinico Umberto I, Rome, in mid-March 2020, with suspicion of COVID-19 infection. Objective: The rRT-PCR was negative and the following CT scan, performed to exclude false-negative results and help diagnosis, was inconclusive. Methods: It was decided to submit the patient to 99mTc-HMPAO-labelled leukocyte scan. Results: This exam led to the diagnosis of infective endocarditis. Conclusion: In the present pandemic scenario, 99mTc-HMPAO-labelled leukocyte scan represents a reliable imaging technique for differential diagnosis with COVID-19 in patients with confusing clinical signs, possible false-negative rRT-PCR results and inconclusive CT scan.

Chronic mesenteric ischaemia presenting as possible large bowl malignancy: an easily overlooked differential diagnosis

2021 ◽  
Vol 14 (3) ◽  
pp. e240202
Author(s):  
Benjamin McDonald
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Weight Loss ◽  
Differential Diagnosis ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Mesenteric Ischaemia ◽  
Abdominal Symptoms ◽  
Chronic Mesenteric Ischaemia ◽  
Descending Colon

An 80-year-old woman presented to a regional emergency department with postprandial pain, weight loss and diarrhoea for 2 months and a Computed Tomography (CT) report suggestive of descending colon malignancy. Subsequent investigations revealed the patient to have chronic mesenteric ischaemia (CMI) with associated bowel changes. She developed an acute-on-chronic ischaemia that required emergency transfer, damage control surgery and revascularisation. While the patient survived, this case highlights the importance of considering CMI in elderly patients with vague abdominal symptoms and early intervention to avoid potentially catastrophic outcomes.

scholarly journals Uptake of exogenous estrogen as a differential diagnosis of ovarian-remnant-syndrome in a bitch: a case report

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Sebastian Ganz ◽  
Axel Wehrend
Keyword(s):  
Differential Diagnosis ◽  
Case Report ◽  
Luteinizing Hormone ◽  
Clinical Signs ◽  
Menopausal Symptoms ◽  
Case Presentation ◽  
Estrogen Exposure ◽  
Exogenous Estrogen ◽  
Endocrine Parameters

Abstract Background Clinical signs of heat in bitches that have been previously spayed are often associated with the presence of ovarian remnant syndrome. The inclusion of exogenous estrogens as a differential diagnosis in this regard is often ignored and may lead to misinterpretation of the case. Case presentation Herein, we report a case of exogenous estrogen exposure over several months to a 6.5-year-old spayed crossbred bitch, weighing 8.4 kg. The bitch presented in the clinic because of suspected ovarian remnant syndrome. Castration was performed within the first 6 months after birth. Important endocrine parameters measured at the first appointment were Anti-Müllerian hormone (< 0.01 ng/mL), progesterone (0.36 ng/mL), estradiol-17ß (20.7 pg/mL), and luteinizing hormone (< 0.1 ng/mL). After an extensive conversation with the owner, it was revealed that she was using an estrogen spray because of severe menopausal symptoms. After the owner stopped using this spray, the symptoms of the bitch disappeared. Conclusion Therefore, the uptake of estrogens should be a differential diagnosis for symptoms of the ovarian remnant syndrome. A detailed anamnesis is crucial to identify the source of estrogen in the environment of the affected bitch.

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