Sonographic diagnosis of a presumed ureteral tear in a horse.
A 14-year-old thoroughbred gelding was presented for the evaluation of acute abdominal pain. Rectally, there was a soft fluctuant painful swelling dorsal to the bladder and to the right of the midline. The creatinine concentration of the peritoneal fluid was 15 mg/dl. Transrectal ultrasonographic examination of the urinary tract revealed a large collection of fluid dissecting from the pelvic portion of the right ureter ventrally through the right side of the bladder wall and into the retroperitoneal space, and a thickened right ureter and bladder wall at the level of the trigone. Cystoscopically there was moderate hemorrhage within the wall of the bladder. Ultrasonography revealed air within the retroperitoneal fluid collection after ureteral catheterization, confirming the preliminary diagnosis of a tear in the right ureter. The gelding was treated medically. After 48 h of hospitalization, nuclear scintigraphy revealed normal clearance from both kidneys and no apparent leakage from the right ureter. The ureteral tear and urinoma were monitored using transrectal ultrasound until resolution. The horse was successfully returned to racing. This case establishes the value of diagngstic ultrasound in the diagnosis and monitoring of a traumatic ureteral tear in a horse.
Department of Clinical Studies, Section of Sports Medicine and Imaging, School of Veterinary Medicine, New Bolton Center, University of Pennsylvania, 382 West Street Road, Kennett Square, PA 19348, USA.
Olga Seco
OS
Diaz
Laura
L
Zarucco
Brett
B
Dolente
Virginia B
VB
Reef
D015746:Abdominal Pain / Q000209:etiology / Q000662:veterinary; D000818:Animals; D003937:Diagnosis, Differential; D006736:Horses / Q000293:injuries*; D008297:Male; D012421:Rupture / Q000662:veterinary; D014463:Ultrasonography / Q000662:veterinary; D014513:Ureter / Q000000981:diagnostic imaging* / Q000293:injuries*