Ultrasonographic appearance of retained surgical sponges and gauzes in the acute postoperative period: a phantom and cadaveric study.

Retained surgical sponges or gauzes (RSS) are an uncommon complication of exploratory laparotomy surgery and pose a clinically significant risk to the patient. The purpose of this two-part, prospective, descriptive study was to describe the previously uncharacterized ultrasonographic appearance of RSS in phantom and cadaveric models of the acute postoperative period (24-48 h). For the first part of the study, a gelatin phantom containing a woven gauze with a radiopaque marker (radiopaque gauze), a woven gauze with no marker (nonradiopaque gauze), and a laparotomy sponge with a radiopaque marker (radiopaque sponge) was evaluated with ultrasonography. For the second part of the study, a total of 23 gauzes and sponges (of the aforementioned three types) were placed within the peritoneal cavity of 20 cadavers in one of three randomized locations during an exploratory laparotomy laboratory. The cadavers were imaged with ultrasonography 17 h later and still images and video clips were reviewed. The retained surgical sponges and gauzes in the gelatin phantom displayed multiple hyperechoic layers and variable degrees of distal acoustic shadowing. In cadavers, 100% (23/23) of the retained surgical sponges and gauzes displayed a single hyperechoic layer of variable thickness and distal acoustic shadowing. In 95.6% (22/23) retained sponges and gauzes, there was a thin hypoechoic layer noted superficially to the hyperechoic layer. An improved understanding of the ultrasonographic appearance of retained sponges or gauzes in the acute postoperative period may assist in the identification of these objects.

Computed tomographic features of confirmed gallbladder pathology in 34 dogs.

Gallbladder pathology is common in dogs, but published studies describing the computed tomographic (CT) appearance of many gallbladder pathologies are currently lacking. This retrospective, multicenter, cases series, descriptive study evaluated the CT features of confirmed gallbladder pathology in 34 dogs. In this subset of dogs, the most common pathologies included cystic mucosal hyperplasia (15/34, 44.1%), gallbladder wall edema (9/34, 26.5%), gallbladder mucocele (8/34, 23.5%), bactibilia (7/34, 20.6%), cholecystitis (6/34, 17.6%), white bile (6/34, 17.6%), and cholelithiasis (4/34, 11.8%). The presence of intraluminal nodules, gallbladder wall thickening, hyperattenuating material (35-100 HU), and mineral attenuating material (>100 HU) were the most common abnormalities detected. However, overlap of each of these findings with a variety of gallbladder pathologies showed that none of the findings were pathognomonic for any of these pathologies. The presence of any of these CT abnormalities should increase the suspicion of gallbladder pathology and prompt further evaluation of the gallbladder for definitive diagnosis.

Concurrent bullous emphysema, bronchointerstitial pneumonia with necrosis, and tension pneumothorax in an 8-week-old puppy.

An 8-week-old, male, mixed breed puppy was presented because of progressive respiratory distress. Thoracic radiographs revealed innumerable coalescing pulmonary bullae throughout the lungs with increased soft tissue opacity of the remaining pulmonary parenchyma and tension pneumothorax. Necropsy and histopathological findings were compatible with bullous emphysema and marked neutrophilic to histiocytic bronchointerstitial pneumonia with necrosis, bronchiectasis, fibrosis, dystrophic mineralization, and vasculitis with thrombosis. Tests for agents of infectious disease did not reveal an underlying etiological agent. This case highlights the radiographic, gross necropsy, and histopathologic features of a puppy with bullous emphysema and severe bronchointerstitial pneumonia with necrosis.

Un chiot mâle croisé âgé de 8 semaines fut présenté à cause de détresse respiratoire progressive. Des radiographies thoraciques ont révélé un nombre incalculable de bulles pulmonaires coalescentes à travers les poumons avec augmentation de l'opacité des tissus mous du parenchyme pulmonaire restant et un pneumothorax de tension. La nécropsie et les trouvailles histopathologiques étaient compatibles avec de l'emphysème bulleux et une pneumonie broncho-interstitielle neutrophilique et histiocytaire marquée avec nécrose, de la bronchiectasie, de la fibrose, une minéralisation dystrophique et une vasculite avec thrombose. Des tests pour agents infectieux de maladie n'ont pas permis de mettre en évidence un agent étiologique sous-jacent. Ce cas met en évidence les trouvailles radiographiques, de nécropsie et histopathologiques chez un chiot avec emphysème bulleux et pneumonie broncho-interstitielle avec nécrose.(Traduit par Dr Serge Messier).