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犬类胆道疾病的超声检查与外科手术

Ultrasonography and surgery of canine biliary diseases.

作者信息

Vörös K, Németh T, Vrabély T, Manczur F, Tóth J, Magdus M, Perge E

机构信息

Department and Clinic of Internal Medicine, Szent István University, H-1400 Budapest, P.O. Box 2, Hungary.

出版信息

Acta Vet Hung. 2001;49(2):141-54. doi: 10.1556/004.49.2001.2.3.

Abstract

Findings of hepatic and gallbladder ultrasonography were analyzed in 12 dogs with gallbladder and/or extrahepatic biliary tract obstruction and compared with the results of exploratory laparotomy. Hepatic ultrasonography demonstrated normal liver in 2 dogs and hepatic abnormalities in 10 animals. The following ultrasonographic diagnoses were established compared to surgical findings: gallbladder obstruction caused by bile sludge (correct/incorrect: 1/2, surgical diagnosis: choleliths in one case), gallbladder obstruction caused by neoplasm (0/1, surgical diagnosis: mucocele), gallbladder and extrahepatic biliary tract obstruction due to choleliths (3/3), extrahepatic biliary tract obstruction caused by pancreatic mass (1/1) and small intestinal volvulus (1/1). Bile peritonitis caused by gallbladder rupture (4/4) was correctly diagnosed by ultrasound, aided with ultrasonographically-guided abdominocentesis and peritoneal fluid analysis. Rupture of the gallbladder should be suspected in the presence of a small, echogenic gallbladder or in the absence of the organ together with free abdominal fluid during ultrasonography. Laparotomy was correctly indicated by ultrasonography in all cases. However, the direct cause of obstruction could not be determined in 2 of the 12 dogs by ultrasonography alone.

摘要

对12只患有胆囊和/或肝外胆道梗阻的犬的肝脏和胆囊超声检查结果进行了分析,并与剖腹探查结果进行了比较。肝脏超声检查显示2只犬肝脏正常,10只动物肝脏有异常。与手术结果相比,建立了以下超声诊断:胆泥引起的胆囊梗阻(正确/错误:1/2,手术诊断:1例为胆结石),肿瘤引起的胆囊梗阻(0/1,手术诊断:黏液囊肿),胆结石引起的胆囊和肝外胆道梗阻(3/3),胰腺肿块引起的肝外胆道梗阻(1/1)和小肠扭转(1/1)。超声检查联合超声引导下腹腔穿刺及腹腔积液分析,正确诊断了4例胆囊破裂引起的胆汁性腹膜炎。超声检查时,若发现胆囊小且回声增强,或未探及胆囊且腹腔内有游离液体,则应怀疑胆囊破裂。所有病例中,超声检查均正确提示了剖腹探查。然而,仅通过超声检查,12只犬中有2只无法确定梗阻的直接原因。

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