case_images: PMC11150568_01
case_images: Ultrasound images of a dog with bilateral Dioctophyme renale, before and after bilateral nephroscopy to remove the parasites. (A) Preoperative appearance of the right kidney full of tubular structures with hyperechoic borders and a hypoechoic center. (B) Preoperative appearance of the left kidney, with the same structures, restricted to the internal medullary region and renal pelvis. (C, D) Appearance 48 h after the surgical procedure to remove the kidney parasites, with a significant reduction in the length and dilation of the bilateral pelvis. (E, F) Appearance 7 days after the surgical procedure, with a reduction in the hyperechogenicity of the parenchyma and inflammation, as well as a reduction in the dilation of both pelvises. Yellow line:approximate measurement of kidney length in a longitudinal section. Red line:approximate measurement of the area where the parasites were located and dilation of the pelvis.
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case_images: F1
case_images: Abdominal ultrasound confirmed the bilateral presence of parasites (Figures 1A, B). Figures 1A-F shows kidney size and the proportion of pelvic dilation in both kidneys.
case_images: Hyperbaric oxygen therapy and bilateral nephroscopy performed in a dog with bilateral Dioctophyme renale. (A) Monoplace hyperbaric chamber (HVM ) during therapy at 2 ATA pressure. (B) Left kidney with guidewire positioned inside the kidney, after puncture with a 14G catheter. (C) Dilation of the orifice with an Amplatz-type 12 Fr renal dilator. (D) Nephroscopy with a 9.6 Fr rigid cystoscope and irrigation of the renal pelvis with sterile solution.
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case_images: F2
case_images: After administration of the medications, the patient underwent the first session of hyperbaric oxygen therapy (HBOT; Figure 2A). It was punctured in the medial region with a 14 Fr catheter, until urine was obtained, and a hydrophilic guidewire was inserted (Figure 2B). Then, Amplatz-type renal dilators 10, 12, 14, and 16 Fr were used progressively (Figure 2C). After the infusion of saline solution, a parasite was visualized that completely obstructed the ureter (Figure 2D).
case_images: Bilateral nephroscopy to remove Dioctophyme renale in a dog. (A) Insertion of 5-mm laparoscopic Kelly forceps to capture the parasite. (B) Extraction of a female parasite removed from the inside of the right kidney. (C) Final appearance of the 16 Fr orifice (white arrow) through which the parasites were removed from the kidney interior. (D) One male (above) and five females of D. renale removed from a parasitized dog.
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case_images: F3
case_images: Cystoscopy grasping forceps and DeBakey atraumatic forceps were not sufficient for traction, and 5-mm laparoscopic Kelly forceps were used to remove a 33-cm female parasite (Figures 3A, B). The 16 Fr hole (Figure 3C) was closed with a 3-0 polydioxanone suture in a horizontal mattress pattern. In total, the right kidney had three female parasites measuring 38, 42, and 50 cm (Figure 3D).