O'Neill E J, Day M J, Hall E J, Holden D J, Murphy K F, Barr F J, Pearson G R
School of Agriculture, Food Science and Veterinary Medicine, College of Life Sciences, University College Dublin, Dublin 4, Republic of Ireland.
J Small Anim Pract. 2006 Jun;47(6):325-35. doi: 10.1111/j.1748-5827.2006.00012.x.
To evaluate the clinical, clinical pathology, diagnostic imaging, microbiological and pathological features of cholangitis/cholangiohepatitis in the dog.
The study design was a retrospective review of cases of bacterial cholangitis/cholangiohepatitis presented to the University of Bristol during the period 1995 to 2000. The diagnosis was made based on hepatic histopathological findings and positive bile culture results.
Four dogs met the inclusion criteria. Common presenting signs included anorexia (n=4), jaundice (n=4), vomiting (n=4) and pyrexia (n=2). All four dogs had a leucocytosis or neutrophilia reported at some time in their history along with serum bilirubin elevation. In addition, serum alkaline phosphatase and alanine transaminase activity was increased in all of the dogs in which it was measured both before and at the time of referral. In general, the diagnostic imaging findings were non-specific. Organisms cultured from bile aspirates were Escherichia coli (n=3), Clostridium species (n=2) and a faecal Streptococcus species (n=1). Two cases resolved with medical treatment alone; two with concurrent cholecystitis required cholecystectomy. Following surgery, both of these cases showed a resolution of clinical signs.
This report highlights the fact that bacterial cholangitis/cholangiohepatitis with or without concurrent cholecystitis should be considered as a potential differential in dogs presenting with signs referable to biliary tract disease.
评估犬胆管炎/胆管肝炎的临床、临床病理学、诊断影像学、微生物学及病理学特征。
本研究设计为对1995年至2000年期间送至布里斯托大学的细菌性胆管炎/胆管肝炎病例进行回顾性分析。诊断基于肝脏组织病理学检查结果及胆汁培养阳性结果。
四只犬符合纳入标准。常见临床表现包括厌食(n = 4)、黄疸(n = 4)、呕吐(n = 4)及发热(n = 2)。所有四只犬在病程中均有白细胞增多或中性粒细胞增多,同时伴有血清胆红素升高。此外,在转诊前及转诊时进行检测的所有犬中,血清碱性磷酸酶和丙氨酸转氨酶活性均升高。总体而言,诊断影像学检查结果无特异性。从胆汁抽吸物中培养出的微生物有大肠杆菌(n = 3)、梭菌属(n = 2)及粪链球菌属(n = 1)。两例仅通过药物治疗治愈;两例合并胆囊炎的犬需要进行胆囊切除术。术后,这两例犬的临床症状均得到缓解。
本报告强调,无论是否合并胆囊炎,细菌性胆管炎/胆管肝炎均应被视为出现胆道疾病相关症状的犬的潜在鉴别诊断疾病。