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CT – Vascular ring anomaly: persistent aortic arch and megaesophagus in a 5 year old FS Australian Heeler

Case Study

CT – Vascular ring anomaly: persistent aortic arch and megaesophagus in a 5 year old FS Australian Heeler

This 5 year old FS Australian Heeler has a history of regurgitation; heartworm positive. Rads show cranial thoracic mass, megaesophagus; gastrotomy tube placed. R/O thymoma with secondary myasthenia causing the megaesophagus.

This 5 year old FS Australian Heeler has a history of regurgitation; heartworm positive. Rads show cranial thoracic mass, megaesophagus; gastrotomy tube placed. R/O thymoma with secondary myasthenia causing the megaesophagus.

DX

• Vascular ring anomaly: persistent aortic arch with leftsided ligamentum arteriosum • Extraluminal esophageal stricture with cranioventral mediastinal diverticulum and cervical megaesopahgus • No evidence of aspiration pneumonia

Image Interpretation

CT of the head/neck  and thorax – 

The left mandibular salivary gland is decreased in size and presents mildly irregular delineation as well as a non-uniform attenuation and enhancement pattern. The left medial retropharyngeal lymph node presents mild symmetric enlargement with maintained short-to-long axis of < 0.5 and maintained enhancement pattern. 

The thoracic esophagus presents a large diverticulum containing gas, fluid and solid phases cranial to the heart. The aortic arch is to the right of the trachea and esophagus. Abrupt narrowing of the esophageal lumen is noted level with the aortic arch. There is no evidence of a cranioventral mediastinal mass lesion other than the esophageal diverticulum. The lung parenchyma presents two thin walled gas filled cavitary lesions. 

A large amount of free peritoneal gas is noted.

Outcome

Idiopathic pulmonary bullae within the right caudal lobe. There is a undetermined risk of spontaneous bulla rupture that cannot be quantified.
No evidence of thymoma;
Postsurgical leftsided mandibular salivary gland with suspected sialadenitis. The potential of a neoplasia is considered low based on the CT findings.
Reactive regional lymphadenitis;
Post surgical pneumoperitoneum.

Comments

There is no persistent leftsided cranial vena cava. No additional vascular malformation is identified other than the PRAA. The potential of residual perfusion of the ligamentum arteriosum needs to be considered even though there is no evidence of a hemodynamically relevant patent ductus arteriosus.

Patient Information

Patient Name : Foxy Nala Rescue/MPI
Gender : Female, Spayed
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 16_00097

Clinical Signs

  • Regurgitation

Images

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Clinical Signs

  • Regurgitation