chest X-ray 4 month old GSD

Re: chest X-ray 4 month old GSD

ilanit — Thu, 15 Sep 2011 15:20:44 GMT

Well, have to admit, I had never heard of it before either. Was browsing through my X-ray book and found an almost identical picture and started researching it. It's quite uncommon apparently. Dog one day post op seems to be doing very well. No vomiting, but have told them to feed from elevated platform etc, because megaesophagus is still there.

I am presuming the intussusception was secondary to the megaesophagus rather than the other way round, but can't be sure. Was assuming the megaesophagus to be congenital, but I guess I can't exclude PRAA as underlying cause.Thanks for the suggestion Martin, I had not thought about it. Unfortunately the barium X-rays weren't the best quality and were mostly filling the caudal esophagus around stomach and not the cranial part. I think we should repeat them at some point to see if there is narrowing above the heart.

Will try to post the barium X-rays, but my colleague gave them to the owner before I had a chance to take a digital photo.

For who's interested:

https://s3.amazonaws.com/assets.prod.vetlearn.com/79/24e2d09dca11e087120050568d3693/file/PV0710_CaseReport.pdf

Re: chest X-ray 4 month old GSD

Ian Battersby — Thu, 15 Sep 2011 13:04:02 GMT

nice case, only just seen the post . I would be interested to see the barum.

i have only seen a couple of these and they can go down hill pretty quickly due to ischemia of the bowel that develops. so well done

Ian

Re: chest X-ray 4 month old GSD

Richard Carter — Thu, 15 Sep 2011 10:53:37 GMT

[quote user="ilanit"]gastroesophageal intussusception, with both stomach and spleen in esophagus. Reposition and gastropexy was performed.[/quote]

wow - suitably impressed. Never even heard of the condition before! Once had a collie with congenital diaphragmatic hernia, liver all in chest which was absolutely fine until 8 or 9 months age. The clever people at Cambridge sorted that one out

Re: chest X-ray 4 month old GSD

Luciano Nebiante PGCertSAS — Thu, 15 Sep 2011 10:19:26 GMT

Interesting to see also the Barium X-ray.

Any chance to have it posted?

Luciano

Re: chest X-ray 4 month old GSD

Martin Atkinson — Wed, 14 Sep 2011 18:59:40 GMT

Have you addressed why the pup had a megoesphagus - was it due to the intussusception or was the intussusception due to the megoesophagus?

Re: chest X-ray 4 month old GSD

Dagmar Steele — Wed, 14 Sep 2011 17:22:05 GMT

thanks for posting this, I found it very interesting! Hope dog will do well!

Re: chest X-ray 4 month old GSD

ilanit — Wed, 14 Sep 2011 16:35:05 GMT

Just to let you know we did Barium X-ray yesterday and operated the dog today.

She had a gastroesophageal intussusception, with both stomach and spleen in esophagus. Reposition and gastropexy was performed. Thankfully all tissues seemed viable and she is so far making good recovery!

Re: chest X-ray 4 month old GSD

ilanit — Tue, 13 Sep 2011 18:59:49 GMT

I would need a dorso-ventral view to make a full assessment, but this looks like a very large esophagus. The caudal part is filled with some soft tissue opacity that could be just fluid, or a foreign body or the stomach (gastro-esophageal intussusception).

At this point, I would take a dorso-ventral view, then give barium per os (40-50 ml), maintain the dog standing on his hind legs for a few minutes, and take an additional lateral and dorso-ventral views.

Alternatively, you can also do endoscopy of the esophagus, if you have an endoscope.

Re: chest X-ray 4 month old GSD

ilanit — Tue, 13 Sep 2011 17:45:31 GMT

Just got the radiologists reply:

I would need a dorso-ventral view to make a full assessment, but this looks like a very large esophagus. The caudal part is filled with some soft tissue opacity that could be just fluid, or a foreign body or the stomach (gastro-esophageal intussusception). 

At this point, I would take a dorso-ventral view, then give barium per os (40-50 ml), maintain the dog standing on his hind legs for a few minutes, and take an additional lateral and dorso-ventral views.

Alternatively, you can also do endoscopy of the esophagus, if you have an endoscope.

Re: chest X-ray 4 month old GSD

Martin Atkinson — Tue, 13 Sep 2011 16:13:48 GMT

I would suspect persistant right aortic arch and megoesophagus with an inhalation pneumonia so a meal with contrast in followed by immediate X-ray is where I'd go next.

Re: chest X-ray 4 month old GSD

ilanit — Tue, 13 Sep 2011 15:53:54 GMT

Found a picture very similar in my X-ray book: gastroesophageal intussusception: displacement of stomach in caudal part of esophagus

apparently a unusual condition in young male german shepherd puppies with megaesophagus. Could fit here!

Re: chest X-ray 4 month old GSD

Hannah Wynne Richards — Tue, 13 Sep 2011 15:28:43 GMT

Large posterior mass is as far as I'mprepared to go

Wynne

Re: chest X-ray 4 month old GSD

Mark Rowland — Tue, 13 Sep 2011 15:25:41 GMT

Oh dear, I think that needs some contrast in it.