Presentation
Presents with one-month history of increasing weakness and distended abdomen. Recumbent and having difficulty breathing this evening.
Patient Data
The abdomen is distended, and there is poor peritoneal detail throughout the abdomen with a mottled appearance. There is also a mass effect in the cranial abdomen, seen best on the lateral projection caudal to the liver, in the position of the spleen. The remainder of the abdominal organs are obscured by the poor detail.
In the portion of the thorax included, the lungs are retracted with surrounding soft tissue opacity effusion on the lateral and ventrodorsal projection.
Splenic mass may be a hematoma or hemangiosarcoma. Peritoneal effusion may be hemorrhagic or neoplastic. Pleural effusion may be of the same etiology, chyle, transudate, or exudate.
Case Discussion
Ultrasound examination revealed a large splenic mass. Cytology of the abdominal effusion showed acute hemorrhage. Hemorrhagic pleural effusion was also present, and diffuse hemangiosarcoma was suspected. A histologic diagnosis was not pursued.
Peritoneal effusion of varying types are possible and indistinguishable on radiographs. Sampling is required for cytologic diagnosis. Differential diagnoses include
peritoneal effusion (carcinomatosis, peritonitis, hemorrhage, transudate)
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