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Right cranial lung lobe torsion after a diaphragmatic rupture repair in a Jack Russell terrier.

Terzo E, Pink J, Puggioni A, Shiel R, Andreoni V, McAllister H - Ir Vet J (2008)

Bottom Line: A seven-year-old male Jack Russell terrier was presented with a history of coughing, generalised weakness and lethargy 10 days after an abdominal coeliotomy to repair a large diaphragmatic rupture.Thoracic radiographs demonstrated a soft tissue mass in the midcaudal right thoracic cavity.LLT should be considered as a differential diagnosis for respiratory tract disease following diaphragmatic rupture repair.

View Article: PubMed Central - HTML - PubMed

Affiliation: University Veterinary Hospital, University College Dublin, Belfield, Dublin 4, Ireland. eloisa.terzo@ucd.ie.

ABSTRACT
A seven-year-old male Jack Russell terrier was presented with a history of coughing, generalised weakness and lethargy 10 days after an abdominal coeliotomy to repair a large diaphragmatic rupture. Thoracic radiographs demonstrated a soft tissue mass in the midcaudal right thoracic cavity. Ultrasonographic studies, bronchoscopy and subsequent exploratory thoracotomy confirmed a diagnosis of a right cranial lung lobe torsion (LLT), with an anomalous caudodorsal displacement of the affected lobe. LLT should be considered as a differential diagnosis for respiratory tract disease following diaphragmatic rupture repair.

No MeSH data available.


Related in: MedlinePlus

Lateral radiograph (a) showing herniation of abdominal organs into the thoracic cavity. Note the intestinal loops over the cardiac silhouette. Dorsoventral radiograph (b): Note the cranial displacement of the abdominal contents mainly in the right hemithorax.
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Figure 1: Lateral radiograph (a) showing herniation of abdominal organs into the thoracic cavity. Note the intestinal loops over the cardiac silhouette. Dorsoventral radiograph (b): Note the cranial displacement of the abdominal contents mainly in the right hemithorax.

Mentions: Ten days following surgery for a right sided radial and short circumferential diaphragmatic rupture (Figures 1a and 1b), a seven-year old Jack Russell terrier was admitted to the University Veterinary Hospital (UVH) of University College Dublin with an acute onset, one-day history of coughing, increased respiratory effort, weakness and lethargy. Physical examination revealed tachypnoea and a rectal temperature of 37.6°C. Haematological and biochemical values were normal. Thoracic auscultation revealed decreased bronchovesicular sounds and muffled heart sounds over the right hemithorax. Radiographic examination of the thorax showed an increased soft tissue opacity in the right hemithorax in the region of the right middle and caudal lung lobes (Figure 2a). In the dorsocaudal lung fields there was a mixed alveolar-interstitial pattern, with areas of consolidation and vesicular gas pattern, extending from the fifth to the ninth intercostal spaces along the right lateral thoracic wall. Medial to this area, there was a second soft tissue opacity with air bronchograms at the level of the right middle lobe, which was moderately displaced caudally from its normal position (Figure 2b). In both right and left lateral recumbent inspiratory views, there was evidence of an interlobar fissure line in the right cranial thorax at the level of the second and third intercostal spaces, which was suspected to indicate a mild pleural effusion. Additionally, the cardiac silhouette had a triangular shape, with a well-marginated small gas radiolucency cranial and lateral to it, presumably caused by residual entrapped air within the mediastinum as a result of the previous coeliotomy. There was a pronounced right mediastinal shift, suggesting a decrease in the right middle lung lobe volume, a collapse of the right lung lobes or an obstruction of the right cranial and middle bronchi, being all possible conditions that might cause a mediastinal displacement toward the affected side [8]. The terminal part of the trachea was widened, displaced dorsally and kinked towards the right at the level of the third intercostal space. There was also axial rotation of the carina (Figures 2a and 2b).


Right cranial lung lobe torsion after a diaphragmatic rupture repair in a Jack Russell terrier.

Terzo E, Pink J, Puggioni A, Shiel R, Andreoni V, McAllister H - Ir Vet J (2008)

Lateral radiograph (a) showing herniation of abdominal organs into the thoracic cavity. Note the intestinal loops over the cardiac silhouette. Dorsoventral radiograph (b): Note the cranial displacement of the abdominal contents mainly in the right hemithorax.
© Copyright Policy
Related In: Results  -  Collection

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getmorefigures.php?uid=PMC3113866&req=5

Figure 1: Lateral radiograph (a) showing herniation of abdominal organs into the thoracic cavity. Note the intestinal loops over the cardiac silhouette. Dorsoventral radiograph (b): Note the cranial displacement of the abdominal contents mainly in the right hemithorax.
Mentions: Ten days following surgery for a right sided radial and short circumferential diaphragmatic rupture (Figures 1a and 1b), a seven-year old Jack Russell terrier was admitted to the University Veterinary Hospital (UVH) of University College Dublin with an acute onset, one-day history of coughing, increased respiratory effort, weakness and lethargy. Physical examination revealed tachypnoea and a rectal temperature of 37.6°C. Haematological and biochemical values were normal. Thoracic auscultation revealed decreased bronchovesicular sounds and muffled heart sounds over the right hemithorax. Radiographic examination of the thorax showed an increased soft tissue opacity in the right hemithorax in the region of the right middle and caudal lung lobes (Figure 2a). In the dorsocaudal lung fields there was a mixed alveolar-interstitial pattern, with areas of consolidation and vesicular gas pattern, extending from the fifth to the ninth intercostal spaces along the right lateral thoracic wall. Medial to this area, there was a second soft tissue opacity with air bronchograms at the level of the right middle lobe, which was moderately displaced caudally from its normal position (Figure 2b). In both right and left lateral recumbent inspiratory views, there was evidence of an interlobar fissure line in the right cranial thorax at the level of the second and third intercostal spaces, which was suspected to indicate a mild pleural effusion. Additionally, the cardiac silhouette had a triangular shape, with a well-marginated small gas radiolucency cranial and lateral to it, presumably caused by residual entrapped air within the mediastinum as a result of the previous coeliotomy. There was a pronounced right mediastinal shift, suggesting a decrease in the right middle lung lobe volume, a collapse of the right lung lobes or an obstruction of the right cranial and middle bronchi, being all possible conditions that might cause a mediastinal displacement toward the affected side [8]. The terminal part of the trachea was widened, displaced dorsally and kinked towards the right at the level of the third intercostal space. There was also axial rotation of the carina (Figures 2a and 2b).

Bottom Line: A seven-year-old male Jack Russell terrier was presented with a history of coughing, generalised weakness and lethargy 10 days after an abdominal coeliotomy to repair a large diaphragmatic rupture.Thoracic radiographs demonstrated a soft tissue mass in the midcaudal right thoracic cavity.LLT should be considered as a differential diagnosis for respiratory tract disease following diaphragmatic rupture repair.

View Article: PubMed Central - HTML - PubMed

Affiliation: University Veterinary Hospital, University College Dublin, Belfield, Dublin 4, Ireland. eloisa.terzo@ucd.ie.

ABSTRACT
A seven-year-old male Jack Russell terrier was presented with a history of coughing, generalised weakness and lethargy 10 days after an abdominal coeliotomy to repair a large diaphragmatic rupture. Thoracic radiographs demonstrated a soft tissue mass in the midcaudal right thoracic cavity. Ultrasonographic studies, bronchoscopy and subsequent exploratory thoracotomy confirmed a diagnosis of a right cranial lung lobe torsion (LLT), with an anomalous caudodorsal displacement of the affected lobe. LLT should be considered as a differential diagnosis for respiratory tract disease following diaphragmatic rupture repair.

No MeSH data available.


Related in: MedlinePlus