Imaging diagnosis-aortic aneurysm and ureteral obstruction secondary to umbilical artery abscessation in a 5-week-old foal.

This research article describes a case where diagnostic imaging was used to identify a rare medical condition in a 5-week-old foal that presented with fever and blood in its urine. An abdominal ultrasound and a CT scan uncovered multiple issues including a large aortic aneurysm, ureteral obstruction, and an abscess in the umbilical artery, which unfortunately led to the foal being euthanized.

Summary of the Case

• The 5-week-old foal was brought in for evaluation after showing signs of fever and hematuria (blood in the urine) that had been ongoing for three days.
• Cystoscopy, a diagnostic procedure that allows direct visualization of the urinary system, revealed the blood originating from the left ureter, a tube that carries urine from the kidneys to the bladder.

Diagnostic Imaging Findings

• Further investigation via abdominal ultrasonography uncovered several issues. The foal had left hydronephrosis and hydroureter, conditions characterized by swelling of a kidney and the ureter due to a build-up of urine.
• In addition, the ultrasound revealed omphaloarteritis, an inflammation of the umbilical artery. There was also an abscess or a collection of pus that had formed and was communicating with an arterial structure.
• A subsequent CT scan indicated the presence of a large aneurysm, or an excessive localized enlargement of an artery, within the aorta. This aneurysm was found within the center of the umbilical artery abscess.

Treatment and Outcome

• An exploratory celiotomy, a surgical procedure involving the opening of the abdominal cavity, was performed in an attempt to remove the infection.
• However, the infection was found to be nonresectable, meaning it could not be surgically removed.
• Given the serious and life-threatening nature of its condition, euthanasia was chosen as the most humane course of action for the foal.
• Necropsy findings post-euthanasia confirmed the initial diagnosis as accurate.

Significance of the Research

• This case underscores the value of ultrasound and CT imaging in reaching an accurate diagnosis, especially in complex cases involving multiple organ systems.
• It highlights the ability of these imaging techniques to visualize internal structures, detect abnormalities, and guide decisions on treatment strategies.
• The authors suggest that these imaging technologies may be particularly helpful in equine medicine, in which physical examinations and symptoms often fail to reflect the full severity or complexity of a condition.