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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: Two days post-biopsy the clinical condition of the dog acutely deteriorated with fever, dyspnea, ataxia and subcutaneous emphysema.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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Two – days post-biopsy hepatic ultarsonographic image. Approximately the same plane is used and the same acoustic window as Figure 1, revealing echoic gas foci (black arrowheads) at the previous biopsy site. Gallbladder (white star) shows a normal appearance.
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Figure 2: Two – days post-biopsy hepatic ultarsonographic image. Approximately the same plane is used and the same acoustic window as Figure 1, revealing echoic gas foci (black arrowheads) at the previous biopsy site. Gallbladder (white star) shows a normal appearance.

Mentions: Ultrasonography (linear probe VFX 13-5 MHz, Sonoline Antares, Siemens Medical Solution, Mountain View, USA) was done unsedated with the dog in lateral recumbency. A diffusely outlined focal area of severe hyperechogenicity associated with multiple reverberation artefacts was seen in the region of the previous liver biopsy and was considered to be intrahepatic gas (Figure 2). No evidence of pneumoperitoneum, pleural effusion or rupture of the biliary system or gastrointestinal tract was detected. Radiographs confirmed the focal region of radiolucent gas in the liver (Figure 3). Hepatic emphysema due to gas producing bacteria was strongly suspected. The clinical condition of the patient rapidly worsened and the dog died within 3 hours of readmission.


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)

Two – days post-biopsy hepatic ultarsonographic image. Approximately the same plane is used and the same acoustic window as Figure 1, revealing echoic gas foci (black arrowheads) at the previous biopsy site. Gallbladder (white star) shows a normal appearance.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Two – days post-biopsy hepatic ultarsonographic image. Approximately the same plane is used and the same acoustic window as Figure 1, revealing echoic gas foci (black arrowheads) at the previous biopsy site. Gallbladder (white star) shows a normal appearance.
Mentions: Ultrasonography (linear probe VFX 13-5 MHz, Sonoline Antares, Siemens Medical Solution, Mountain View, USA) was done unsedated with the dog in lateral recumbency. A diffusely outlined focal area of severe hyperechogenicity associated with multiple reverberation artefacts was seen in the region of the previous liver biopsy and was considered to be intrahepatic gas (Figure 2). No evidence of pneumoperitoneum, pleural effusion or rupture of the biliary system or gastrointestinal tract was detected. Radiographs confirmed the focal region of radiolucent gas in the liver (Figure 3). Hepatic emphysema due to gas producing bacteria was strongly suspected. The clinical condition of the patient rapidly worsened and the dog died within 3 hours of readmission.

Bottom Line: Two days post-biopsy the clinical condition of the dog acutely deteriorated with fever, dyspnea, ataxia and subcutaneous emphysema.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