Today’s case is a 3 year old domestic long haired cat with suspected trauma. Post your interpretations under the comments section.
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Veterinary Radiology
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February 15th, 2008 at 10:46 am
First view:
There is loss of serosal details in the cranial to mid abdomen.
There is feces visible in the colon. The colon and the left kidney are displaced ventraly.
The urinary bladder is visible, a urinary catheter is visible.
The colon is probably displaced by the right kidney which is displaced by the retroperitoneum.
The skeletal structures seem to be WNL, but in order to determine that, another view is required.
DD´s: for the renal and colon displacement:
retroperitoneal hemprrhage, raptured ureter, retroperitoneal mass.
For the loss of serosal details:
Small amount of free abdominal fluid (blood, urine, inflamatory, neoplastic), peritonitis
Second view:
Contrast media within the urinary bladder. There is a small filling defect in the ventro-dorsal aspect of the bladder. The contrast media is also visible in the retroperitoneal space probably due to a ruptured ureter
February 16th, 2008 at 8:20 am
I wonder about the appearance of the extra-abdominal fat in the inguinal region. There appears to be fluid opacity streaking through this tissue and in the retroperitoneum. Following contrast application there is leakage into the pelvic/perineal region and the inguinal tissues. A ureteral tear may be in play here, but I would be suspicious that the pelvic urethra has also been breached.
Dan
February 17th, 2008 at 7:59 pm
I agree with Dan. On cystography, contrast media leaked maily in the pelvic area, so urethral rupture would be the top differential. Although the ureters might be ruptured in this case, contrast media in the retroperitoneum might not be an evidence of ureteral rupture because it was not IVP but cytography performed on this case.
February 17th, 2008 at 8:57 pm
Nice job everyone. The key is to recognize that a cystogram was performed, and to follow the contrast tracking. Answers are available! Just click on the case link.