Caudal Mediastinal Paraesophageal Abscesses in 7 Dogs

Abstract

CMPA should be suspected when there is regurgitation and pyrexia associated with a mass or enlargement in the caudal mediastinum. CMPA appears to have a good prognosis after aggressive surgical therapy.

Total excision of a caudal mediastinal paraoesophageal abscess in a dog

“…The choice of a left sixth intercostal thoracotomy approach was based on the absence of vascular invasion of the caudal vena cava and oesophageal deviation towards the left on preoperative CT. A more caudal surgical approach at the level of the eighth right intercostal space, as previously reported by Brissot and others (2012), might have been more challenging for the dissection of the CMPA at the level of the caudal vena cava close to the right atrium. It is opined that median sternotomy would have been more challenging for the dissection of the dorsal part of the CMPA.…”

“…In the seven dogs with CMPA reported by Brissot and others (2012) partial resection of the more accessible ventrolateral part of the abscess, with or without omentalisation, was performed using an eighth right intercostal thoracotomy or a median sternotomy. Full resection of the abscess cavity was not possible in any case because of its close association with the oesophagus medially and the aorta dorsally.…”

“…Caudal mediastinal masses reported in dogs include non-pulmonary paraoesophageal abscesses (Brissot and others 2012, Haudiquet and others 2014), oesophageal granulomas (Dvir and others 2001), oesophageal tumours (Dvir and others 2001), gastric tumours (Wang and others 2002), peripheral nerve sheath tumours (Essman and others 2002), malignant histiocytosis (Ramsey and others 1996), pyogranulomas (Sivacolundhu and others 2001) and pseudocysts (Aulakh and others 2011). …”

“…Clinical, imaging and surgical findings and outcome associated with non-pulmonary caudal mediastinal paraoesophageal abscesses (CMPAs) have been recently reported in seven dogs (Brissot and others 2012). All dogs were successfully treated surgically with drainage and partial resection of the CMPA followed by oral administration of antibiotics for at least two weeks after surgery.…”

Mediastinectomy for management of chronic pyogranulomatous pleural disease in dogs

“…Diseases of the mediastinal pleura are uncommon but include neoplasia, mediastinitis and chronic abscessation (Radlinsky 2012). Mediastinitis and mediastinal abscessation have been most commonly reported as a complication of pyothorax (Rooney and Monnet 2002, Schultz and Zwingenberger 2008, Franklin and others 2011, Brissot and others 2012), the underlying cause for which is often suspected to be inhaled or ingested foreign material (Koutinas and others 2003, Brissot and others 2012). Even if there is no single breed predilection, hunting and working-type dogs are reported to be over-represented (Demetriou and others 2002, Rooney and Monnet 2002, Scott and Macintire 2003b, Johnson and Martin 2007).…”