Case Study

RAD – Soft tissue emphysema lower neck, possible trauma in a coughing 7 year old MN Dachshund/terrier mix

This 7 year old MN Dachshund/terrier mix dog presented for tense abdomena and hacking cough

DX

¥ Possible mild soft tissue emphysema in the lower neck, possible mild pneumomediastinum ¥ Respiratory distress or pain induced aerophagia ¥ Mild bronchointerstitial pattern

Image Interpretation

Rads of the thorax and abdomen –

thorax –

The lung volume is as expected. Moderate aerophagia is noted which likely is owing to respiratory distress or pain. The esophagus contains a mild amount of gas cranial to the heart and is seen as a gas filled tube cranial to the thoracic aperture. Possible small linear and round gas accumulations highlight the external walls of the caudal cervical and cranial thoracic esophagus. Leven with and caudal to the heart the esophagus is not seen. No mediastinal widening is noted. The lung reveals a mild generalized bronchointerstitial pattern which is likely to be an incidental age related finding.

abdomen –

Minor reduction of the serosal detail is noted within the cenral abdomen owing to crowding of small intestinal loops. Moderate aerophagia is noted which likely is owing to respiratory distress or pain. The small intesinal loops are of even, non-dilated diameter but turgid.

Outcome

The history doesn’t mention a trauma. However, the radiogrpahic findings warrant clinical correlation and reexamination for a possible injury of the cervical soft tissue or along the upper repiratory (larynx, trachea) or digestive (esophagus) tract. The lung pattern is most likely incidental and age related. However, owing to the history of hacking cough further workup with tracheobronchoscopy may be considered for further workup here since it allows for rule out of differential diagnoses such as tracheitis/laryngitis, bronchial collapse and allergic or infectious (viral, and unlikely bacterial/fungal) bronchitis all at once.