2013 Radiology Exam - Thorax Case 1

History

  • 10 year old M/N German Shepherd
  • Presented for tachypnea and cough

Observations:

  • Generalized megaesophagus
  • Ventral distribution of an alveolar pattern
  • Abnormal position of pylorus in cranial abdomen on right lateral thoracic image

Synthesis:

  • GDV (or at least volvulus, with only moderate dilatation of stomach)
  • Megaesophagus is likely secondary to the GDV, although other differentials for megaesophagus are possible
  • Aspiration pneumonia secondary to megaesophagus, regurgitation, vomiting

This case basically tested satisfaction of search. If the candidate missed the GDV, the case was essentially failed, although partial credit was awarded for description of the megaesophagus and aspiration pneumonia.

A right lateral view of the abdomen was available on request (last image), although full credit was given for the diagnosis of the GDV if it was diagnosed without the abdomen view.