2007 Radiology Exam - Thorax Case 2

Information provided to the candidate

• Sg: 2 month old filly
• Hx: Presented for respiratory distress, lethargy, anorexia
• Rads: Left lateral view of the thorax

See image below. Click to enlarge.

Candidates received points for:

• Dilated fluid and air filled thoracic esophagus with fluid-air interface
• Diffuse mixed interstitial and alveolar pulmonary pattern
• Poorly defined radiolucencies within the caudo-ventral alveolar pattern

Radiographic Diagnosis:

• Megaesophagus: differentials of idiopathic, ulcers, aerophagia (less likely due to fluid accumulation); probably incidental to pulmonary pathology
• Hematogenous pneumonia with possible abscess formation: differentials of bacterial etiologies including Rodococcus. Aspiration pneumonia possible but less likely given distribution

Outcome:
Foal was euthanized. A cause of megaesophagus was not determined. Rodococcus was cultured from lungs