Medical management of traumatic hepatic parenchymal emphysema in a dog.

A 4-year-old intact female dachshund dog was presented in shock after a traumatic event. The dog had sustained hemoperitoneum and pulmonary contusions. Veterinary point-of-care ultrasound revealed reverberation artifacts inside the liver. Abdominal ultrasonography and computed tomography identified these as lesions of hepatic emphysema. Biochemical analysis showed marked elevation of liver enzymes. Treatments included S-adenosylmethionine and broad-spectrum antibiotics, among others. Two weeks following trauma, alanine aminotransferase was near normal and there was almost complete resolution of the hepatic lesions on abdominal ultrasonography. This case report is the first to describe the medical management and time course of parenchymal hepatic emphysema in a dog following trauma. It also focuses on the diagnosis of hepatic emphysema using various imaging modalities. Key clinical message: Hepatic parenchyma emphysema can develop following blunt abdominal trauma and appears as bright, hyperechoic foci with reverberation artifacts that can be easily observed with veterinary point-of-care ultrasonography or complete abdominal ultrasonography. Hepatic emphysema does not always require surgical treatment. Monitoring biochemical abnormalities and lesions with various imaging modalities, along with providing supportive treatments, can sometimes be sufficient.