Intermittent Haemoptysis due to an Aortobronchial Fistula in a Warmblood Mare.

A 7-year-old warmblood mare showed sudden onset of mild intermittent haemoptysis. Clinical examination revealed no significant abnormalities. Haematological examination showed mild anaemia, hypoalbuminaemia and neutrophilia. Coagulation tests were normal. Endoscopic examination revealed unilateral pulmonary haemorrhage with blood clots in the bronchi and trachea. Treatment with antibiotics was started and the horse was given stable rest. Two weeks later, the horse was found dead with blood and frothy sputum leaking from the nostrils. Post-mortem examination revealed a large thoracic aortic aneurysm communicating with a pseudoaneurysm that had formed a fistula into a right bronchial branch. Microscopical examination of the aneurysm showed extensive medial fibrosis with prominent degeneration, fragmentation and mineralization of the elastic fibres and deposition of mucoid material in the tunica media. The pseudoaneurysm was lined by collagen bundles admixed with fibroblasts and a small amount of adipose tissue. Aortobronchial fistula is a rare condition in man that is usually associated with primary aortic pathology, most often aneurysms. To the authors' knowledge this is the first case of a fatal aortobronchial fistula in a horse or any other animal species.

Computed tomographic features of pneumothorax secondary to a bronchopleural fistula in two dogs.

A bronchopleural fistula (BPF) can lead to continuous pneumothorax and is rarely reported clinically in dogs. This report describes computed tomographic (CT) findings in two dogs with BPFs and subsequent continuous pneumothoraces that necessitated thoracotomy. Both dogs had a peripheral BPF in the right caudal lung lobe. The fistula in one dog was secondary to a previous foreign body migration, and the fistula in the other was thought to be secondary to dirofilariasis. On both CT examinations, a dilated subsegmental bronchus was seen communicating with the pleural space at the center of a focal, concave region of parenchymal consolidation. Multiplanar reformatting aided in identification and characterization of the BPF. The pneumothoraces resolved after right caudal lobectomy in both dogs. CT has the potential to identify BPFs, such as secondary to foreign body migration or dirofilariasis.

Iatrogenic pneumothorax associated with inadvertent intrapleural NGT misplacement in two dogs.

This case report presents two cases of inadvertent intrapleural nasogastric tube (NGT) misplacement with consequent creation of a bronchopleural fistula and the development of an iatrogenic pneumothorax in dogs. Due to the simplicity and relative ease of NGT placement and the lack of reported life-threatening complications in the veterinary literature, the serious risks associated with this procedure are often overlooked. Although pulmonary complications with NGT misplacement have been previously reported in the human literature, serious and potentially fatal complications have not been currently described in veterinary patients. Both of the cases described herein were medically managed with successful outcomes; however, one case was associated with significant morbidity.

Chronic bronchocutaneous fistula caused by toothpick foreign body in a Maltese dog.

A 7-year-old, 1.76 kg Maltese dog presented with a 4-year history of a chronic pustular lesion and a wet cough. Erosive lesions were seen at the left thoracic wall. Radiology and computed tomography (CT) revealed a bronchocutaneous fistula connecting from the left cranial bronchus to the skin. On definitive surgery, a long wooden toothpick was observed within this tract, and clinical signs resolved after retrieval of the foreign body. Three-dimensional CT was useful to identify the characteristics of the bronchocutaneous fistula. However, the wooden foreign body was not apparent on CT. Here, we report the clinical, clinicopathological and diagnostic imaging findings of a chronic bronchocutaneous fistula caused by a foreign body in a dog.

Canine bronchoesophageal fistulas: case report and literature review.

A bronchoesophageal fistula (BEF) is defined as a communication between the esophagus and one or more bronchi. BEFs are commonly associated with esophageal diverticula, which are circumscribed outpouchings of the esophageal wall. This article presents the report of a case seen at Louisiana State University Veterinary Teaching Hospital and Clinics in 2006 and reviews the pathogenesis, diagnosis, and treatment of esophageal diverticula and BEFs. The BEF in the case presented was of a very rare form, involving only the accessory lung lobe bronchus.

Fluoroscopic and endoscopic localization of an esophagobronchial fistula in a dog.

A 10-month-old, intact male Chihuahua presented for a 7-month history of regurgitation and coughing. Survey radiographs revealed a soft-tissue opacity within the distal esophagus. A contrast study confirmed the presence of an esophagobronchial fistula. Endoscopic removal of foreign material within the esophagus allowed for visualization of an esophageal diverticulum. Bronchoscopic examination revealed the presence of an abnormal opening in a right caudal tertiary bronchus. Passage of a cardiac guidewire was accomplished, confirming the presence of the fistula and aiding its subsequent surgical removal.

Bronchocutaneous fistula in a dog.

A dog with a bronchocutaneous fistula is described. Contrast enhanced computed tomography was useful for diagnosis and treatment of the fistula in this dog.

Surgical treatment of a congenital bronchoesophageal fistula in a dog.

A 1-year-old male Cairn Terrier was evaluated for chronic coughing that was aggravated by eating or drinking. Radiography revealed an esophageal diverticulum, regional megaesophagus, and focal interstitial densities in the right caudal and middle lung lobes. Using fluoroscopy and contrast radiography, contrast material was seen to accumulate in the diverticulum and to reflux into the right middle, caudal, and accessory bronchi. Radiographic diagnosis was bronchoesophageal fistula. Via right eighth intercostal space thoracotomy, the abnormal connection between esophagus and caudal lobe of the right lung was identified, the lobe was resected, and the esophagus was closed. Histologic examination of the connecting tissue revealed a lining of stratified epithelium, with the superficial layer being predominantly ciliated columnar epithelium. Several findings led to the conclusion that the fistula was a congenital lesion, arising from aberrant formation of the respiratory tract from the embryologic digestive tract. Histologic examination revealed smooth muscle and lack of inflammation in tissue surrounding the fistula, which are criteria for identifying congenital bronchoesophageal fistula in human patients. The dog was young and did not have a history of esophageal foreign bodies. Postoperative complications were not encountered, and 9 months later, the dog was reported to be eating dry dog food without coughing. Congenital and acquired bronchoesophageal fistulas in dogs are reported infrequently. Furthermore, 2 of 12 previously reported bronchoesophageal fistulas in dogs, one of which was considered congenital, developed in Cairn Terriers.

Surgical diseases of the esophagus.

The diagnosis and management of surgical diseases of the esophagus are discussed. Esophageal foreign bodies, strictures, esophagobronchial fistulas, diverticula, gastroesophageal intussusception, hiatal hernias, and megaesophagus are included in the discussion.

Bronchoesophageal fistula and transient megaesophagus in a dog.

Bronchoesophageal fistula and megaesophagus were diagnosed in a dog. Within 2 days after surgical correction of the bronchoesophageal fistula, peristalsis in the thoracic portion of the esophagus returned to normal and the esophagus resumed its normal size. The cause of the fistula was attributed to damage from a foreign body. The cause of the transient megaesophagus likely was related to the bronchoesophageal fistula.