DOI QR코드

DOI QR Code

Ultrasonographic and Computed Tomographic Appearance of Spontaneous Cutaneous Fistula Resulted from Retained Surgical Gauze in a Dog

  • Hwang, Tae-sung (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Huh, Chan (Yangsan S Animal Medical Center) ;
  • Lee, Hee-chun (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University)
  • Received : 2019.03.12
  • Accepted : 2019.08.01
  • Published : 2019.08.30

Abstract

A 6-year-old, spayed female Maltese was presented with the condition of a chronic recurrent abscess formation in the left flank region. Despite the antibiotics and drainage therapy given to the dog, the lesion formed a continued serosanguineous to the point that a purulent discharge was evident. In the meantime, an abdominal ultrasound revealed the presence of a well-defined mass with a hypoechoic outer margin, and a hyperechoic inner rim in the cranial of the kidney. A fistula was noted as being present with a connection between the subcutaneous lesion of the left flank and the abdominal mass. It is emphasized that CT scans revealed the existence of a soft tissue dense mass with low attenuation area, as seen in some internal areas and also a peripheral contrast enhancement was noted within a nonenhancing central region. There was additional nonenhancing fluid found dorsal to the inflammatory tract passing under the epaxial muscles and at the peritoneum. Likewise, the tract exited the skin surface in the left flank. A tentative diagnosis of an abdominal abscess with spontaneous cutaneous fistula was made based on the ultrasonographic and CT appearances. A foreign body such as surgical gauze should always be considered a potential cause of draining tract in small animals, as was considered to be the problem in this case.

Keywords

References

  1. Ansari M, Singh I, Dogra P. Spontaneous nephrocutaneous fistula-2 unusual case reports with review of literature. Int Urol Nephrol 2004; 36: 239-243. https://doi.org/10.1023/B:UROL.0000034685.64057.80
  2. Armbrust LJ, Biller DS, Radlinsky MG, Hoskinson JJ. Ultrasonographic diagnosis of foreign bodies associated with chronic draining tracts and abscesses in dogs. Vet Radiol Ultrasound 2003; 44: 66-70. https://doi.org/10.1111/j.1740-8261.2003.tb01452.x
  3. Bani-Hani KE, Gharaibeh KA, Yagha RJ. Retained surgical sponges (gossypiboma). Asian J Surg 2005; 28: 109-115. https://doi.org/10.1016/S1015-9584(09)60273-6
  4. Brennan K, Ihrke P. Grass awn migration in dogs and cats: a retrospective study of 182 cases. J Am Vet Med Assoc 1983; 182: 1201-1204.
  5. Bryniak S. Primary spontaneous renocutaneous fistula. Urology 1983; 21: 516-517. https://doi.org/10.1016/0090-4295(83)90056-0
  6. Forster K, Anderson D, Yool D, Wright C, Burrow R. Retained surgical swabs in 13 dogs. Vet Rec 2011; 169: 337. https://doi.org/10.1136/vr.d4396
  7. Frank JD, Stanley BJ. Enterocutaneous fistula in a dog secondary to an intraperitoneal gauze foreign body. J Am Anim Hosp Assoc 2009; 45: 84-88. https://doi.org/10.5326/0450084
  8. Frendin J, Funkquist B, Hansson K, Lonnemark M, Carlsten J. Diagnostic imaging of foreign body reactions in dogs with diffuse back pain. J Small Anim Pract 1999; 40: 278-285. https://doi.org/10.1111/j.1748-5827.1999.tb03080.x
  9. Govarjin HM, Talebianfar M, Fattahi F, Akbari ME. Textiloma, migration of retained long gauze from abdominal cavity to intestine. J Res Med Sci 2010; 15: 54.
  10. Johnson-neitman JL, Bahr RJ, Broaddus KD. Fistula formation secondary to a nylon cable band in a dog. Vet Radiol Ultrasound 2006; 47: 355-357. https://doi.org/10.1111/j.1740-8261.2006.00153.x
  11. Kohli S, Singhal A, Tiwari B, Singhal S. Gossypiboma, varied presentations: A report of two cases. J Clin Imaging Sci 2013; 3: 11.
  12. Kopka L, Fischer U, Gross AJ, Funke M, Oestmann JW, Grabbe E. CT of retained surgical sponges (textilomas): pitfalls in detection and evaluation. Comput Assist Tomogr 1996; 20: 919-923. https://doi.org/10.1097/00004728-199611000-00009
  13. Kunkle G. Differential diagnosis of nodules and draining tracts in the cat. Vet Int 1993; 1: 3-9.
  14. Lamb CR, White RN, Mcevoy FJ. Sinography in the investigation of draining tracts in small animals: retrospective review of 25 cases. Vet Surg 1994; 23: 129-134. https://doi.org/10.1111/j.1532-950X.1994.tb00457.x
  15. Mai W, Ledieu D, Venturini L, Fournel C, Fau D, Palazzi X, Magnol J. Ultrasonographic appearance of intra-abdominal granuloma secondary to retained surgical sponge. Vet Radiol Ultrasound 2001; 42: 157-160. https://doi.org/10.1111/j.1740-8261.2001.tb00919.x
  16. Mentes BB, Yilmaz E, Sen M, Kayhan B, Gorgul A, Tatlicioglu E. Transgastric migration of a surgical sponge. J Clin Gastroenterol 1997; 24: 55-57. https://doi.org/10.1097/00004836-199701000-00013
  17. Merlo M, Lamb CR. Radiographic and ultrasonographic features of retained surgical sponge in eight. Vet Radiol Ultrasound 2000; 41: 279-283. https://doi.org/10.1111/j.1740-8261.2000.tb01491.x
  18. Miller WH, Griffin CE, Campbell KL, Muller GH. Diagnostic methods. In: Muller and Kirk's Small Animal Dermatology 7th, Elsevier Health Sciences, St. Louis, Missouri 2013: 101-103.
  19. Niknam R, Mahmoudi L, Nasiri S, Merat S. A Case with a Fistula Draining into the Stomach due to Retained Surgical Gauze. Middle East J Dig Dis 2010; 2: 116-117.
  20. Oh K, Son C, Park C. Spontaneous nephro-cutaneous fistula with pyonephrosis in two dogs: two case reports. Vet Med (Praha) 2017; 62: 44-47. https://doi.org/10.17221/184/2015-VETMED
  21. Rivers BJ, Walter PA, Feeney DA, Johnston GR. Ultrasonographic features of intestinal adenocarcinoma in five cat. Vet Radiol Ultrasound 1997; 38: 300-306. https://doi.org/10.1111/j.1740-8261.1997.tb00859.x
  22. Stanley BJ, Hauptman JG. Long-term prospective evaluation of topically applied 0.1% tacrolimus ointment for treatment of perianal sinuses in dogs. J Am Vet Med Assoc 2009; 235: 397-404. https://doi.org/10.2460/javma.235.4.397
  23. Sturdy J, Baird R, Gerein A. Surgical sponges: a cause of granuloma and adhesion formation. Ann Surg 1967; 165: 128-134. https://doi.org/10.1097/00000658-196701000-00017
  24. Tonolini M, Magistrelli P. Enterocutaneous fistulas: a primer for radiologists with emphasis on CT and MRI. Insights Imaging 2017; 8: 537-548. https://doi.org/10.1007/s13244-017-0572-3
  25. Ukwenya A, Dogo P, Ahmed A, Nmadu P. The retained surgical sponge following laparotomy; forgotten at surgery, often forgotten at diagnosis. Our experience. Niger J Surg 2006; 8: 164-168.
  26. Wan YL, Huang TJ, Huang DL, Lee TY, Tsai CC. Sonography and computed tomography of a gossypiboma and in vitro studies of sponges by ultrasound case report. Clin Imaging 1992; 16: 256-258. https://doi.org/10.1016/0899-7071(92)90008-W
  27. Wattanasirichaigoon S. Transmural migration of a retained surgical sponge into the intestinal lumen: an experimental study. J Med Assoc Thai 1996; 79: 415-422.