2008 Abdomen Case 2

"Biscuit" -- 2 view abdomen

  -3 year old Yorkshire Terrier spayed female

  -hit by bicycle

 

See images below. Click to enlarge. Click magnifying glass at the bottom of enlarged images for full-sized image.


Radiographic Findings:

  -loops of small intestine outside body wall in left ventral/inguinal region

  -no visible urinary bladder

  -increased soft tissue opacity in retroperitoneal space

  -right SI luxation

  -left iliac body, right ischial, and bilateral pubic fractures

  -wispy subcutaneous soft tissue in lumbar region

 

Radiographic Diagnoses:

  -body wall herniation with small intestine in left inguinal region

  -possible urine leakage or hemorrhage in retroperitoneal space

  -possible ruptured urinary bladder

 

Recommendations:

  -Excretory urography (once patient hydrated and stable) preferred over cystography, since we need to evalute kidneys and ureters

  - +/- ultrasound of abdomen to evaluate for free fluid, etc

  -surgery to repair hernia, fractures

  -complete thoracic radiographs

 

Candidate performance:

The retroperitoneal space and lack of urinary bladder visualization was missed by some candidates. The recommendation for excretory urography and why was not consistent.

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