Imaging Diagnosis: The Abdominal Air‐vasculogram in a Dog With Splenic Torsion and Clostridial Infection

Abstract

Prior to presentation, the dog had apathy for 3 days and vomiting for 1 day. Since then, the dog had been anorectic and become progressively apathetic. The dog presented in lateral recumbency and was becoming stuporous. Clinical findings included white, dry mucous membranes, and it was not possible to determine capillary refill time. Bounding femoral pulses were detected, and the dog had a very large, firm abdomen. The dog did not experience pain on abdominal palpation. Percussion of the abdomen was negative. The dog had a heart rate of 164 beats per minute, respiratory rate of 36 breaths per minute and a temperature of 37°C. The dog's hematocrit was 21%, and the albumin level was 31.2 g/l, both at the lower limit of normal. The white blood count was elevated at 17,800 cells/l with a left shift, and relative monocytosis and lymphopenia. The dog had no previous illnesses. Anemia and hypovolemic shock were diagnosed, and the dog was suspected of having a splenic torsion. Other differential diagnoses included gastric dilation and torsion, rupture of the gastrointestinal tract with peritonitis, abdominal hemorrhage, and pancreatitis. Radiographic and Ultrasonographic FindingsLateral and dorsoventral radiographs of the abdomen were made. The dog's discomfort prevented it from being positioned on its back, so a dorsoventral radiograph of the abdomen was obtained. The abdomen was large with generalized loss of detail. A 20-cm long heterogeneous, illdefined, space-occupying lesion that contained numerous small round to irregularly shaped gas opacities was localized to the right midventral abdomen (Fig. 1). The stomach and small intestines were not distinguishable, and further From the Depdrtment of Clinical Veterinary Medicine, Divisions of Radiology (Gaschen, Kircher, and Lang) and Surgery (Venzin and Hurter),

Postmortem Abdominal Radiographic Findings in Feline Cadavers

“…Antemortem detection of intrasplenic gas has been reported in dogs with splenic torsion. 35,36 In one of the reported patients, there was concurrent gas-forming bacterial infection of Closrtidium sp. with splenic torsion.…”

Diagnostic imaging for the assessment of acquired abdominal vascular diseases in small animals: A pictorial review

“…Organ torsion is an acute cause of vascular compromise that shows characteristic imaging features with both ultrasound and MDCT. Torsions of parenchymatous organs have been reported in small animals for the liver, spleen, and pancreas …”

“…With ultrasound, imaging findings in patients with acute splenic torsion include splenomegaly, round splenic margins, increased echogenicity of the peritoneal fat surrounding the spleen, presence of a hyperechoic triangle at the level of the splenic hilum, thrombosis of the splenic vein and its branches, and reduced to absent splenic blood flow . Free gas in the splenic parenchyma has also been reported due to emphysematous splenitis as complication of the splenic torsion …”

Serial postmortem abdominal radiographic findings in canine cadavers

“…This was mainly due to centrifugal movement of gas in the portal vein. In the later stage, vesicular gas pattern dominated in both liver and spleen [26]. The changes of the gas pattern seen are probably due to escape of gas from the intraparenchymal blood vessels into the parenchyma secondary to autolysis of both organs [22].…”