13-year-old male intact mixed breed dog
2018 Image Interpretation - Case 4
section content
- During the process of laparotomy (cystotomy for urocystoliths removal), abdominal purulent material was found.
- So the laparotomy was aborted.
- Computed tomography was performed to rule out pancreatic lesion.
Pre-Contrast
Post-Contrast
- Focal region of increased soft tissue density in the peripheral aspect of the right caudal lung lobe that contains multiple mineral dense foci and several irregularly shaped gas bubbles.
- There is a moderate amount of fluid throughout the peritoneal space. The fluid is hyperattenuating to urine in the urinary bladder.
- Large, sharply-marginated, irregularly shaped mass in the left liver (likely left medial lobe). The mass is composed of numerous variably sized, thin-walled pockets of fluid. The outer margin of the mass and fluid pockets enhance moderately with contrast. This mass causes bulging of the liver capsule.
- The mass contains linear and round, mineral attenuating foci.
- Mulitple locations at which the gastric serosal margins and abnormal portions of the liver cannot be distinguished.
- Ventrally orientated outpouching of the gastric wall that contacts the mass. Within the outpouching there is a hypoattenuating tract that seems to contact the abnormal liver. On the post contrast series this hypoattenuating tract also seems to communicate with the gastric lumen and displaces the pylorus to the left.
- A second, smaller hypoattenuating mass in the cranial aspect of the left lateral liver lobe was noted. There is mild peripheral contrast enhancement of the mass. This mass contains two thinner, mineral attentuating linear structures in it.
- There was heterogenous contrast enhancement of the hepatic lymph nodes.
- A focally enlarged, rounded portion of the pancreas was noted.
- The spleen was rounded and caudally displaced.
- Multiple small hypoattenuating, non-enhancing foci in the left renal cortex which likely represent degenerative cysts. There were no urinary bladder cystoliths, urethroliths or ureteroliths.
- Hyperattenuating foci in the medial iliac lymph nodes.
- The incision along the caudoventral body wall on midline is noted with a few small gas bubbles in the subcutaneous tissues and adjacent peritoneal space.
- A focal thickening of the ventral wall of the urinary bladder with a small gas bubble is also noted, consistent with the recent cystotomy that was performed.
- A small sharply marginated, soft tissue dense nodule in the subcutaneous fat, adjacent to the proximal aspect of teh left femur with minimal to no contrast enhancement is noted.
- A larger nodule in the skin and subcutaneous fat to the right of the anus is noted.
- Cholangiocarcinoma
- Gallbladder sludge and cholelithiasis
- Degenerative renal cortical cysts
- Mineral dense intestinal material
- Orthopedic changes