Antemortem diagnosis of external iliac arterial thromboembolism in a calf using contrast-enhanced computed tomography: a case report

Figures

• 

  Fig. 1.. Right lateral (left) and left lateral thorax radiographs. The thoracic radiographs showed an alveolar pattern and air bronchograms in the cranial lobes (arrows).

• 

  Fig. 2.. Pre-contrast computed tomography (CT) image with a lung window (A, B), and post-contrast image with a soft-tissue window (C). Air bronchograms were depicted in the right cranial lobe (red arrow, A). A gas in the ring-enhancement mass (C, 34 × 35 mm), was observed in the right cranial lobe. The yellow arrows show a gas in the mass.

• 

  Fig. 3.. The pre- and post-contrast CT image and three-dimensional (3D) image. In the pre-contrast image, the shape of the trunk at the sacro-lumbar section exhibited asymmetry, suggesting atrophy of the right gluteal and femoral muscles, and diffuse fluid-attenuation areas were present in the right hind limb (A). In post-contrast images, arterial vessels were depicted in the first phase, whereas a contrast defect, indicating thrombosis in the external iliac artery, was detected in contrast-enhanced CT (yellow arrow, B). The lesion was also visualized in 3D-CT (yellow arrow, C).

• 

  Fig. 4.. Pathological findings. The right external iliac artery descending about 5.5 cm from the bifurcation of the abdominal aorta was dilated, and an ocher thrombus was found inside (white arrow, A). Hematoxylin–eosin (HE) staining of the thrombus showed neutrophilic infiltration, and Gram staining showed a small number of Gram-positive streptococci (B). The abscess was found in the right cranial lobes (C). HE staining of the lungs revealed multiple abscesses covered with connective tissue, and Gram staining showed Gram-positive streptococci in the pus (D).