RESUMO
OBJECTIVE: To assess the thickness of each layer of the gallbladder wall with different diseases in dogs. SAMPLE: 72 gallbladders. METHODS: Retrospective study of dogs that underwent cholecystectomy. Histopathological specimens of the gallbladders were reviewed. Histopathological diagnosis was made as gallbladder mucocele or cholecystitis, and cholecystitis was further categorized into chronic cholecystitis, acute-on-chronic cholecystitis, acute cholecystitis, and necrotic cholecystitis. The thickness of each layer of the gallbladder wall was measured. RESULTS: 22 dogs were diagnosed with gallbladder mucocele without cholecystitis, 24 with gallbladder mucocele and cholecystitis, 20 with only cholecystitis, and 6 as normal. Histopathological subclassification of cholecystitis in 44 gallbladders led to diagnosis of chronic cholecystitis in 21 gallbladders, acute-on-chronic cholecystitis in 10 gallbladders, acute cholecystitis in 6 gallbladders, and necrotic cholecystitis in 7 gallbladders. The thickness of the entire wall of the gallbladder (P < .0001) and the thickness of the mucosa (P < .0001) and subserosa (P < .0001) were affected by the different disease processes. CLINICAL RELEVANCE: Layers of the gallbladder wall were affected by diseases present in the gallbladder. It resulted in a difference in the thickness of the wall of the gallbladder among the gallbladder diseases in this study. Histopathological changes should be taken into consideration before surgery while deciding what technique to use to perform a cholecystectomy.
Assuntos
Colecistite , Doenças do Cão , Vesícula Biliar , Mucocele , Animais , Cães , Mucocele/veterinária , Mucocele/patologia , Mucocele/cirurgia , Estudos Retrospectivos , Vesícula Biliar/patologia , Vesícula Biliar/cirurgia , Colecistite/veterinária , Colecistite/patologia , Colecistite/cirurgia , Doenças do Cão/patologia , Doenças do Cão/cirurgia , Masculino , Feminino , Colecistectomia/veterinária , Doenças da Vesícula Biliar/veterinária , Doenças da Vesícula Biliar/patologia , Doenças da Vesícula Biliar/cirurgiaRESUMO
Background: Iatrogenic gallbladder perforation during laparoscopic cholecystectomy (LC) is a common complication and occurs in at least one third of human patients undergoing LC. This is attributed to the fragility of the gallbladder wall associated with mucocele and cholecystitis, in addition to the need for repetitive gripping and traction of the gallbladder during its manipulation with laparoscopic instruments. As complications from this event are rare in human patients, conversion to laparotomy is not routinely indicated and the adverse consequences of bile spillage are minimized by abundant irrigation of the peritoneal cavity and adequate antimicrobial therapy. On the other hand, there is little information regarding the outcome of laparoscopic management of this complication in laparoscopic cholecystectomies in dogs, particularly since most surgeons indicate conversion in these cases. Thus, we describe a case of biliary peritonitis that developed in a dog after laparoscopic management of iatrogenic perforation of the gallbladder during a laparoscopic cholecystectomy, in a case of gallbladder mucocele. To the best of our knowledge, there are no reports of biliary peritonitis following laparoscopic management of iatrogenic gallbladder perforation during LC in dogs. Case: A 14-year-old Poodle was referred for clinical evaluation with selective appetite, recurrent episodes of hyporexia, and abdominal discomfort. Ultrasound findings characterized chronic liver disease and gallbladder mucocele. The patient was referred for laparoscopic cholecystectomy, during which the gallbladder was iatrogenically perforated, with extravasation of a large volume of bile content. This complication was managed by copious abdominal irrigation via laparoscopic access and antimicrobial therapy. On the second postoperative day, the patient started to present apathy, hyporexia, emesis, and jaundice. The patient remained hospitalized in the intensive care unit for stabilization and monitoring through hematological examinations and serial abdominal ultrasound. Due to progressive worsening of the clinical picture, an exploratory laparotomy was performed ten days after the initial surgical procedure. This examination showed multiple adhesions and the presence of bile residues adhered to numerous points on the peritoneal surface and pancreas. Despite the intensive treatment instituted, death occurred 10 h after the second surgical procedure. Discussion: The high risk of gallbladder perforation during laparoscopic cholecystectomies correlates with the dissection step or repetitive grasping and traction of the gallbladder with laparoscopic instruments. Conversion is not routinely indicated and laparoscopic management is considered effective in humans. However, in this case, the presence of a large volume of extravasated semisolid bile content and its adherence to the mesothelial surface made it impossible to remove it in its entirety despite the abundant irrigation of the abdominal cavity, resulting in a picture of biliary peritonitis in the postoperative period. In view of the reported negative outcome, the authors encourage the adoption of measures that minimize the risk of gallbladder perforation when performing LC in dogs. These include the use of atraumatic instruments or aspiration of bile content before surgical manipulation. Cases in which such a complication is recorded should be carefully monitored to enable early diagnosis and treatment of biliary peritonitis. Furthermore, conversion should be considered when there is extravasation of large volumes of bile, particularly in the presence of gallbladder mucocele, until future studies establish the safety and effectiveness of laparoscopic management of this complication.
Assuntos
Animais , Feminino , Cães , Peritonite/veterinária , Ruptura/veterinária , Vesícula Biliar/lesões , Mucocele/veterinária , Colecistectomia Laparoscópica/efeitos adversos , Procedimentos Cirúrgicos Minimamente Invasivos/veterináriaRESUMO
Background: Capillaria hepatica is a nematode, zoonotic, with worldwide distribution. The main hosts are rodents, nevertheless other mammals can be affected. Although the parasite has high affinity for the liver, it rarely causes a hepaticdisease in domestic animals and humans. The diagnosis is difficult and usually a biopsy is required. The treatment is difficult and is based in anti-helminthic and corticoid, but prevention is the best strategy against the disease. The aim of thepresent report is to describe a case of hepatic capillariosis in a dog approaching the clinical signs, diagnosis and therapeutic.Case: A 12-year-old Brazilian Terrier bitch, with a history of visit to the farm and regular hunting of rats, frogs, birds andother wild animals, was attended with hyporexia and apathy. At the physical exam the dog presented elevation of rectaltemperature, intense jaundice and abdominal pain. In the biochemical exams was noticed a slight increase in globulins anda sharp increase in alkaline phosphatase (AP), total, direct and indirect bilirubin, suggesting a liver injury. In the ultrasonographic exam, hepatomegaly with dispersed hyperechoic areas were observed, suggesting hepatic steatosis. The patientwas treated with ursodesoxicolic acid and S-adenosil metionin for 30 consecutive days, showing a clinic improvement.Two months after the end of the treatment the animal worsened, showing jaundice, ascites, motor incoordination, weakness, difficulty in food and water ingestion and changes in the mental state. In the complete blood count was observed amacrocytic hypochromic regenerative anemia, leukocytosis with neutrophilia and monocytosis and thrombocytopenia.In biochemical exams was detected decrease in creatinine and albumin and increase in alanine aminotransferase and AP,suggesting hepatopathy by biliary obstruction. There were performed exams for leishmania and ehrlichiosis that testednegative. In the ultrasonographic exam it...(AU)
Assuntos
Animais , Feminino , Cães , Capillaria , Infecções por Enoplida/veterinária , Cães/parasitologia , Icterícia/veterinária , Ultrassonografia/veterinária , Mucocele/veterinária , Peritonite/veterinária , Biópsia/veterináriaRESUMO
Background: Capillaria hepatica is a nematode, zoonotic, with worldwide distribution. The main hosts are rodents, nevertheless other mammals can be affected. Although the parasite has high affinity for the liver, it rarely causes a hepaticdisease in domestic animals and humans. The diagnosis is difficult and usually a biopsy is required. The treatment is difficult and is based in anti-helminthic and corticoid, but prevention is the best strategy against the disease. The aim of thepresent report is to describe a case of hepatic capillariosis in a dog approaching the clinical signs, diagnosis and therapeutic.Case: A 12-year-old Brazilian Terrier bitch, with a history of visit to the farm and regular hunting of rats, frogs, birds andother wild animals, was attended with hyporexia and apathy. At the physical exam the dog presented elevation of rectaltemperature, intense jaundice and abdominal pain. In the biochemical exams was noticed a slight increase in globulins anda sharp increase in alkaline phosphatase (AP), total, direct and indirect bilirubin, suggesting a liver injury. In the ultrasonographic exam, hepatomegaly with dispersed hyperechoic areas were observed, suggesting hepatic steatosis. The patientwas treated with ursodesoxicolic acid and S-adenosil metionin for 30 consecutive days, showing a clinic improvement.Two months after the end of the treatment the animal worsened, showing jaundice, ascites, motor incoordination, weakness, difficulty in food and water ingestion and changes in the mental state. In the complete blood count was observed amacrocytic hypochromic regenerative anemia, leukocytosis with neutrophilia and monocytosis and thrombocytopenia.In biochemical exams was detected decrease in creatinine and albumin and increase in alanine aminotransferase and AP,suggesting hepatopathy by biliary obstruction. There were performed exams for leishmania and ehrlichiosis that testednegative. In the ultrasonographic exam it...
Assuntos
Feminino , Animais , Cães , Capillaria , Cães/parasitologia , Infecções por Enoplida/veterinária , Biópsia/veterinária , Icterícia/veterinária , Mucocele/veterinária , Peritonite/veterinária , Ultrassonografia/veterináriaRESUMO
The present report aimed to describe the main characteristics of the parotid salivary mucocele in an adult male rabbit, which presented with a painless fluctuating mass with fluid content. Owing to the need for repeated fluid drainage, surgical excision was the chosen mode of treatment. Preoperative evaluation included radiography and blood analysis. The patient underwent surgical excision of the affected gland. Inhalation anesthesia was maintained by means of isoflurane and the cardio-respiratory parameters were monitored throughout the surgery. A bipolar electrocautery was used to assist in the incision and polyglactin 910 and nylon were the suture materials used in the wound closure technique. Post-operative medications included analgesics, anti-inflammatory agents and antibiotics. Histopathology of the excised glandular tissue revealed a mixed inflammatory infiltrate, fibroblasts, hemorrhage and hyperemia. The observations in this case suggest that surgical excision of the affected gland is the treatment of choice for the management of mucocele in companion rabbits, which has already been identified for other animals. Periodic acid-reactive Schiff staining confirmed the diagnosis of salivary mucocele. The complementary investigations helped to rule out the differential diagnosis and indicated a favorable prognosis, in view of the fact that the case was successfully resolved without complications or recurrence.(AU)
O presente relato teve como objetivo descrever as principais características da mucocele salivar parotídea em um coelho macho adulto, que apresentou uma massa flutuante indolor e com um conteúdo líquido em seu interior. Devido à necessidade de repetidas punções deste fluido, optou-se pela excisão cirúrgica como forma de tratamento. A avaliação pré-operatória incluiu radiografias e análises sanguíneas. O paciente foi submetido ao tratamento cirúrgico com excisão da glândula afetada. A anestesia inalatória foi mantida com isoflurano e os parâmetros cardio-respiratórios foram monitorados durante a cirurgia. Um eletrocautério bipolar foi utilizado para auxiliar na incisão e os fios poliglactina 910 e nylon foram utilizados na técnica de sutura. As medicações pós-operatórias incluíram agentes analgésicos, anti-inflamatórios e antibióticos. A histopatologia do tecido glandular removido revelou infiltrado inflamatório misto, fibroblastos, hemorragia e hiperemia. As observações neste caso sugerem que a remoção cirúrgica da glândula afetada seja o tratamento de escolha no manejo da mucocele em coelhos de companhia, o que já vem sendo identificado para outros animais. A coloração do ácido periódico reativo de Schiff confirmou o diagnóstico da mucocele salivar. Os exames complementares ajudaram a excluir as doenças que fazem parte do diagnóstico diferencial e indicaram um prognóstico favorável, tendo em vista o fato que este caso foi resolvido com sucesso, sem complicações ou recorrência.(AU)
Assuntos
Animais , Masculino , Coelhos , Glândulas Salivares/cirurgia , Região Parotídea/cirurgia , Mucocele/veterinária , Reação do Ácido Periódico de Schiff/veterináriaRESUMO
A mucocele de vesícula biliar se caracteriza pelo acúmulo anormal de bile semissólida na vesícula biliar. O presente trabalho relata o caso de uma cadela idosa, da raça yorkshire atendida em um Hospital Veterinário particular (Serviço Médico Veterinário SEMEVE), com quadro de vômitos, anorexia, prostração e tremores, iniciados no dia do atendimento. Durante a anamnese, a tutora relatou que a paciente tinha sido diagnosticada há três anos com dislipidemia, sendo descartadas afecções endócrinas como causa do quadro. Ao exame físico, o animal apresentava sensibilidade à palpação abdominal e discreta icterícia em esclera. Durante o ultrassom de abdômen foi diagnosticada a mucocele de vesícula biliar, através da ecogenicidade, padrão apresentado pela bile e histórico clínico do animal. O tratamento inicial foi com antibioticoterapia, fluidoterapia suplementada com vitamina b e potássio, analgésico, antiemético e protetor gástrico. Devido a piora do quadro apresentada nos exames, 48 horas após o internamento, foi realizada colecistectomia. No transcirúrgico identificou-se aderência do omento à vesícula biliar e líquido ao redor dela. Foi realizada cultura com antibiograma da bile e mantida a terapia alopática. O histopatológico da vesícula biliar apontou colecistite aguda supurada. A cultura isolou a bactéria Sthapylococcus intermedius. Após 60 dias de realizada a cirurgia, o animal encontrava-se clinicamente saudável e como os exames para controle apontaram resolução completa das alterações, foi dada alta médica.
The gallbladder mucocele (GBM) is characterized by abnormal accumulation of semisolid bile in the gallbladder. This case repor is about a female dog, Yorkshire, attended on a private Veterinary Hospital (Serviço Médico Veterinário SEMEVE). The dog had vomiting, anorexia, prostration and tremors that started on the day of the appointment. During the anamnesis, the tutor reported that the patient had been diagnosed with dyslipidemia three years before, however, endocrine disorders were ruled out as the cause of the condition. At the physical examination, the animal presented sensitivity to abdominal palpation and mild sclera jaundice. During the abdominal ultrasound it was diagnosed gallbladder mucocele, through echogenicity and the pattern presented by the bile associated with the clinical history of the animal. The initial treatment was with antibiotic therapy, fluid therapy supplemented with vitamin B and potassium, analgesic, antiemetic and gastric protector. Due to the worsening of the dog seen in the exams, 48 hours after admission, cholecystectomy was performed. In the transurgical procedure, omentum adherence to the gallbladder and fluid around it was identified. Culture with bile antibiogram was performed and allopathic therapy was maintained. The histopathology of the gallbladder showed acute suppurated cholecystitis. The culture isolated the bacterium Sthapylococcus intermedius. After 60 days of the surgery, the animal was clinically healthy and the tests for control showed complete resolution of the changes, so it was given medical discharge.
Assuntos
Animais , Cães , Doenças do Cão , Mucocele/diagnóstico , Mucocele/terapia , Mucocele/veterinária , Vesícula Biliar/anormalidadesRESUMO
A mucocele de vesícula biliar se caracteriza pelo acúmulo anormal de bile semissólida na vesícula biliar. O presente trabalho relata o caso de uma cadela idosa, da raça yorkshire atendida em um Hospital Veterinário particular (Serviço Médico Veterinário SEMEVE), com quadro de vômitos, anorexia, prostração e tremores, iniciados no dia do atendimento. Durante a anamnese, a tutora relatou que a paciente tinha sido diagnosticada há três anos com dislipidemia, sendo descartadas afecções endócrinas como causa do quadro. Ao exame físico, o animal apresentava sensibilidade à palpação abdominal e discreta icterícia em esclera. Durante o ultrassom de abdômen foi diagnosticada a mucocele de vesícula biliar, através da ecogenicidade, padrão apresentado pela bile e histórico clínico do animal. O tratamento inicial foi com antibioticoterapia, fluidoterapia suplementada com vitamina b e potássio, analgésico, antiemético e protetor gástrico. Devido a piora do quadro apresentada nos exames, 48 horas após o internamento, foi realizada colecistectomia. No transcirúrgico identificou-se aderência do omento à vesícula biliar e líquido ao redor dela. Foi realizada cultura com antibiograma da bile e mantida a terapia alopática. O histopatológico da vesícula biliar apontou colecistite aguda supurada. A cultura isolou a bactéria Sthapylococcus intermedius. Após 60 dias de realizada a cirurgia, o animal encontrava-se clinicamente saudável e como os exames para controle apontaram resolução completa das alterações, foi dada alta médica.(AU)
The gallbladder mucocele (GBM) is characterized by abnormal accumulation of semisolid bile in the gallbladder. This case repor is about a female dog, Yorkshire, attended on a private Veterinary Hospital (Serviço Médico Veterinário SEMEVE). The dog had vomiting, anorexia, prostration and tremors that started on the day of the appointment. During the anamnesis, the tutor reported that the patient had been diagnosed with dyslipidemia three years before, however, endocrine disorders were ruled out as the cause of the condition. At the physical examination, the animal presented sensitivity to abdominal palpation and mild sclera jaundice. During the abdominal ultrasound it was diagnosed gallbladder mucocele, through echogenicity and the pattern presented by the bile associated with the clinical history of the animal. The initial treatment was with antibiotic therapy, fluid therapy supplemented with vitamin B and potassium, analgesic, antiemetic and gastric protector. Due to the worsening of the dog seen in the exams, 48 hours after admission, cholecystectomy was performed. In the transurgical procedure, omentum adherence to the gallbladder and fluid around it was identified. Culture with bile antibiogram was performed and allopathic therapy was maintained. The histopathology of the gallbladder showed acute suppurated cholecystitis. The culture isolated the bacterium Sthapylococcus intermedius. After 60 days of the surgery, the animal was clinically healthy and the tests for control showed complete resolution of the changes, so it was given medical discharge.(AU)
Assuntos
Animais , Cães , Doenças do Cão , Mucocele/diagnóstico , Mucocele/terapia , Mucocele/veterinária , Vesícula Biliar/anormalidadesRESUMO
Background: Sialocele or salivary mucocele is the accumulation of saliva in the glandular connective tissue due to a leakage from damaged salivary duct, which is surrounded by granulation tissue. The mucocele can be classified according to its location (cervical, pharyngeal or sublingual, the latter being known as ranula). The treatment consists of salivary gland and duct excision. However, in some cases, the definition of which side is affected is a challenge for surgeons. Keeping this in view, the aim of the present study was to describe the use of rigid endoscopy to determine the affected gland in a dog with cervical mucocele.Case: A five-year-old Dachshund, weighting 8.2 kg, was presenting progressive swelling in the ventral cervical area. The animal presented apathy, appetite loss and saliva drooling. A fluctuant, non-painful, fluid filled mass was noted on physical examination. Sialocele was diagnosed and surgery was undertaken to excise the involved gland and mass. The patient was positioned in dorsal recumbence. A skin incision was performed in the cranial-ventral aspect of the mass as it was not possible to precise the affected side. Following drainage of the content, the inner aspect of the sialocele capsule was digitally palpated using the surgeons index finger. However, it was still not possible to determinate the affected side...
Assuntos
Animais , Cães , Ductos Salivares/cirurgia , Glândulas Salivares/cirurgia , Mucocele/veterinária , Vértebras Cervicais , Endoscopia/veterináriaRESUMO
Background: Sialocele or salivary mucocele is the accumulation of saliva in the glandular connective tissue due to a leakage from damaged salivary duct, which is surrounded by granulation tissue. The mucocele can be classified according to its location (cervical, pharyngeal or sublingual, the latter being known as ranula). The treatment consists of salivary gland and duct excision. However, in some cases, the definition of which side is affected is a challenge for surgeons. Keeping this in view, the aim of the present study was to describe the use of rigid endoscopy to determine the affected gland in a dog with cervical mucocele.Case: A five-year-old Dachshund, weighting 8.2 kg, was presenting progressive swelling in the ventral cervical area. The animal presented apathy, appetite loss and saliva drooling. A fluctuant, non-painful, fluid filled mass was noted on physical examination. Sialocele was diagnosed and surgery was undertaken to excise the involved gland and mass. The patient was positioned in dorsal recumbence. A skin incision was performed in the cranial-ventral aspect of the mass as it was not possible to precise the affected side. Following drainage of the content, the inner aspect of the sialocele capsule was digitally palpated using the surgeons index finger. However, it was still not possible to determinate the affected side...(AU)
Assuntos
Animais , Cães , Mucocele/veterinária , Vértebras Cervicais , Glândulas Salivares/cirurgia , Ductos Salivares/cirurgia , Endoscopia/veterináriaRESUMO
Conforme Dunnig (2007) não é recomendado o tratamento apenas por aspiração ou drenagem, devido à ocorrência de recidiva em poucos dias. A relevância clínica deste caso está relacionada à viabilidade da cricotireoidotomia para melhora da angústia respiratória e a utilização da técnica de marsupialização como tratamento eficaz, pois não ocorreu recidiva no caso relatado, embora a realização dessa técnica possa apresentar comprometimento da via aérea superior e possibilidade de disfunção da deglutição em caso de recidiva.