Imaging Characteristics of Bronchopericardial Fistulas in a Dog

A 7-year-old, spayed female, Afghan Hound presented for evaluation of fever, lethargy, and cough. Initial thoracic radiographs revealed increased soft tissue opacity of the left cranial lung lobe, mild pneumopericardium, and mild pleural effusion. Subsequent computed tomography (CT) of the thorax demonstrated multiple bronchopericardial fistulas, measuring up to 6.0 mm in diameter, originating from a secondary bronchus of the caudal subsegment of the left cranial lung lobe. The pericardial sac was markedly dilated, containing both fluid and gas. Associated findings included pulmonary atelectasis of the left cranial and caudal lung lobes, regional lymphadenopathy, and minimal left caudal pleural effusion. The dog recovered uneventfully following left cranial and partial left caudal lung lobectomies with subtotal pericardiectomy, with resolution of clinical signs and no effusion on 2-week follow-up ultrasound. On the basis of the reviewed literature, this is the first case report describing CT findings of bronchopericardial fistulas in a dog.