Читать книгу Small Animal Surgical Emergencies - Группа авторов - Страница 152

Survey cervical and thoracic radiographs identify most esophageal foreign bodies. Radiographic indicators of esophageal perforation include (Figure 4.4):

 Pneumomediastinum

 Pneumothorax

 Periesophageal fluid collection [6]. This sign may be subtle and even a careful search of the radiographic image may not disclose a perforation.

 Mediastinal widening. This sign is often evident on dorsoventral views (Figure 4.5).

Aqueous iodinated contrast media or barium may be introduced both to delineate radiolucent foreign bodies and to declare sites of esophageal perforation and leakage, although perforations plugged by the foreign body itself may not permit the contrast agent to issue extraluminally [7]. A stomach tube should be advanced along the esophagus toward the foreign body before infusing sufficient contrast agent to distend the esophagus.

Figure 4.4 Pneumomediastinum and pneumothorax following forceps retrieval of a bone foreign body from the esophagus. The trachea, esophagus, and great vessels are abnormally clearly delineated because of the pneumomediastinum. A thoracic drain has just been placed.

Figure 4.5 A markedly widened caudal mediastinum is seen here, due to the presence of an esophageal foreign body, on this dorsoventral radiographic projection.