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Hepatic emphysema associated with ultrasound-guided liver biopsy in a dog.

Westgren F, Hjorth T, Uhlhorn M, Etterlin PE, Ley CJ - Acta Vet. Scand. (2014)

Bottom Line: Post-mortem examination revealed chronic hepatitis with dissecting fibrosis, acute hepatitis with hemorrhage and in the hindlimb musculature extensive hemorrhage and necrosis.Pure cultures of the gas producing bacteria Clostridium perfringens were isolated in samples from the hind limb musculature.We propose that the hepatic emphysema in the region of the biopsy site was a result of a clostridial infection.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Diagnostic Imaging, University Animal Hospital, Swedish University of Agricultural Sciences, Box 7040, Uppsala 75007, Sweden. frida.westgren@uds.slu.se.

ABSTRACT
An eleven-year-old Chinese Crested Powder Puff dog presented with polydipsia/polyuria, inappetence, diarrhea and vomiting underwent an ultrasound-guided percutaneous liver biopsy. Two days post-biopsy the clinical condition of the dog acutely deteriorated with fever, dyspnea, ataxia and subcutaneous emphysema. Radiographs and ultrasound showed focal severe hepatic emphysema in the region of the previous liver biopsy. Post-mortem examination revealed chronic hepatitis with dissecting fibrosis, acute hepatitis with hemorrhage and in the hindlimb musculature extensive hemorrhage and necrosis. Pure cultures of the gas producing bacteria Clostridium perfringens were isolated in samples from the hind limb musculature. We propose that the hepatic emphysema in the region of the biopsy site was a result of a clostridial infection.

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Initial hepatic ultrasonographic image. An oblique plane is used with a ventral acoustic window, showing part of the gallbladder (white star), rounded liver margin (black arrow) and heterogenous parenchyma.
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Figure 1: Initial hepatic ultrasonographic image. An oblique plane is used with a ventral acoustic window, showing part of the gallbladder (white star), rounded liver margin (black arrow) and heterogenous parenchyma.

Mentions: Abdominal ultrasonography, using a high-frequency transducer (9 MHz linear probe, GE Medical LOGIQ 9, General Electric Medical Systems, Wisconsin, USA), was done with the dog in dorsal recumbency and unsedated. The liver was considered mildly enlarged with rounded margins and in all liver lobes focal rounded variably sized areas of mixed echogenicity and smaller hypoechoic areas were seen (Figure 1). Differential diagnosis considered were hepatitis, steroid hepatopathy, lymphoma, hepatocellular carcinoma, metastasis and amyloidosis, possibly associated with nodular hyperplasia. A mild homogenous echoic pattern was seen in the dependant portion of the gallbladder with some smaller (approximately 5 mm) more echoic non-acoustic shadowing structures in the region of the neck of the gallbladder. This was considered most likely to be a suspension of variably concentrated bile pigment precipitates (sludge) and cholestasis was considered as a possible cause, but there was no sign of obstruction of the bile ducts. Both kidneys had normal size and shape but had increased echogencity of the cortex and medulla and a mildly decreased corticomedullary definition. Several small rounded hypoechoic structures most likely representing nodular hyperplasia or neoplasia were seen in the right pancreatic lobe.


Hepatic emphysema associated with ultrasound-guided liver biopsy in a dog.

Westgren F, Hjorth T, Uhlhorn M, Etterlin PE, Ley CJ - Acta Vet. Scand. (2014)

Initial hepatic ultrasonographic image. An oblique plane is used with a ventral acoustic window, showing part of the gallbladder (white star), rounded liver margin (black arrow) and heterogenous parenchyma.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4020358&req=5

Figure 1: Initial hepatic ultrasonographic image. An oblique plane is used with a ventral acoustic window, showing part of the gallbladder (white star), rounded liver margin (black arrow) and heterogenous parenchyma.
Mentions: Abdominal ultrasonography, using a high-frequency transducer (9 MHz linear probe, GE Medical LOGIQ 9, General Electric Medical Systems, Wisconsin, USA), was done with the dog in dorsal recumbency and unsedated. The liver was considered mildly enlarged with rounded margins and in all liver lobes focal rounded variably sized areas of mixed echogenicity and smaller hypoechoic areas were seen (Figure 1). Differential diagnosis considered were hepatitis, steroid hepatopathy, lymphoma, hepatocellular carcinoma, metastasis and amyloidosis, possibly associated with nodular hyperplasia. A mild homogenous echoic pattern was seen in the dependant portion of the gallbladder with some smaller (approximately 5 mm) more echoic non-acoustic shadowing structures in the region of the neck of the gallbladder. This was considered most likely to be a suspension of variably concentrated bile pigment precipitates (sludge) and cholestasis was considered as a possible cause, but there was no sign of obstruction of the bile ducts. Both kidneys had normal size and shape but had increased echogencity of the cortex and medulla and a mildly decreased corticomedullary definition. Several small rounded hypoechoic structures most likely representing nodular hyperplasia or neoplasia were seen in the right pancreatic lobe.

Bottom Line: Post-mortem examination revealed chronic hepatitis with dissecting fibrosis, acute hepatitis with hemorrhage and in the hindlimb musculature extensive hemorrhage and necrosis.Pure cultures of the gas producing bacteria Clostridium perfringens were isolated in samples from the hind limb musculature.We propose that the hepatic emphysema in the region of the biopsy site was a result of a clostridial infection.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Diagnostic Imaging, University Animal Hospital, Swedish University of Agricultural Sciences, Box 7040, Uppsala 75007, Sweden. frida.westgren@uds.slu.se.

ABSTRACT
An eleven-year-old Chinese Crested Powder Puff dog presented with polydipsia/polyuria, inappetence, diarrhea and vomiting underwent an ultrasound-guided percutaneous liver biopsy. Two days post-biopsy the clinical condition of the dog acutely deteriorated with fever, dyspnea, ataxia and subcutaneous emphysema. Radiographs and ultrasound showed focal severe hepatic emphysema in the region of the previous liver biopsy. Post-mortem examination revealed chronic hepatitis with dissecting fibrosis, acute hepatitis with hemorrhage and in the hindlimb musculature extensive hemorrhage and necrosis. Pure cultures of the gas producing bacteria Clostridium perfringens were isolated in samples from the hind limb musculature. We propose that the hepatic emphysema in the region of the biopsy site was a result of a clostridial infection.

Show MeSH
Related in: MedlinePlus