Lynch Alex M, O'Toole Therese E, Rush John E, Rondeau Danielle, O'Neill Kelly, Kudej Raymond K
Department of Clinical Sciences, Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, 01536.
Peak Veterinary Referral Center, Williston, VT, 05495.
J Vet Emerg Crit Care (San Antonio). 2015 Nov-Dec;25(6):795-800. doi: 10.1111/vec.12379. Epub 2015 Oct 16.
To describe a case of acute tracheal compression due to a dorsal tracheal membrane abscess in a dog.
A 3-year-old intact male Bluetick Coonhound presented for evaluation of 36 hours of marked inspiratory dyspnea and stridor. A radiographic diagnosis of tracheal collapse was made on thoracic radiographs, which was confirmed to be static compression by tracheoscopy. Dorsal extraluminal tracheal compression from a fluid filled structure adjacent to the trachea was suspected based on ultrasonography. Endoscopic-guided transtracheal fine needle aspiration yielded septic suppurative inflammation. At surgery an abscess in the dorsal tracheal membrane was identified, lanced, and lavaged, which resulted in restoration of normal tracheal diameter. The dog developed bilateral pneumothorax, which was treated medically by thoracostomy tube placement and manual evacuation of the accumulated air. Postoperative radiographs also revealed evidence of pneumomediastinum. Pneumothorax and pneumomediastinum likely occurred secondary to the surgical approach, worsened by positive pressure ventilation. Cultures of the abscess isolated a nonhemolytic Streptococcus species but with no evidence of anaerobic bacteria. The dog made a full functional recovery.
Tracheal compression is a rare diagnosis in dogs. To the authors' knowledge, this represents the first report of an abscess in the dorsal tracheal membrane, diagnosed by endoscopic-guided transtracheal fine needle aspiration, causing clinically relevant acute tracheal obstruction.
描述一例犬背侧气管膜脓肿导致急性气管受压的病例。
一只3岁未绝育的雄性蓝斑寻血猎犬因36小时的明显吸气性呼吸困难和喘鸣前来评估。胸部X光片做出气管塌陷的影像学诊断,经气管镜检查证实为静态压迫。基于超声检查怀疑气管旁一个充满液体的结构导致气管背侧管腔外受压。内镜引导下经气管细针穿刺抽吸得到脓性化脓性炎症。手术中发现背侧气管膜有一个脓肿,切开并冲洗,气管直径恢复正常。该犬出现双侧气胸,通过放置胸导管和手动排出积聚的气体进行药物治疗。术后X光片还显示有纵隔气肿的迹象。气胸和纵隔气肿可能继发于手术操作,正压通气使其加重。脓肿培养分离出一种非溶血性链球菌,但无厌氧菌证据。该犬功能完全恢复。
气管受压在犬中是一种罕见的诊断。据作者所知,这是第一例通过内镜引导下经气管细针穿刺抽吸诊断出背侧气管膜脓肿导致临床相关急性气管阻塞的报告。