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犬自发性外胆道瘘

Spontaneous external biliary fistula in a dog.

作者信息

Kligman Kara C, Jehn Carl T, Davis Kechia M, Taylor David P, Conway Julia A

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126, USA.

出版信息

J Am Vet Med Assoc. 2007 Sep 15;231(6):919-23. doi: 10.2460/javma.231.6.919.

Abstract

CASE DESCRIPTION

A 10-year-old sexually intact female dog was examined because of a static, well-circumscribed subcutaneous mass and associated fistulous draining tract located along the right ventrolateral aspect of the thoracic body wall of 15 months' duration.

CLINICAL FINDINGS

Results of computed tomography and fistulography confirmed the presence of the fistulous tract. Computed tomography also revealed a focal, hypodense region in the right ventral portion of the liver that was adjacent to but not clearly associated with the fistulous tract.

TREATMENT AND OUTCOME

Surgical exploration of the tract revealed that it passed into the right hemithorax to the diaphragm; entered the right medial lobe of the liver; and terminated in a well-encapsulated, cystic liver lesion. The right medial liver lobe and all affected tissues were removed. Histologically, the liver lesion consisted of a fibrotic, dilated bile duct. The dilated bile duct and fistula were lined with biliary epithelium. On the basis of these findings, a diagnosis of spontaneous external biliary fistula was made. Five months after surgery, the dog was clinically normal.

CLINICAL RELEVANCE

To the authors' knowledge, spontaneous external biliary fistula in a dog has not been reported in the veterinary medical literature. Despite the rarity of this condition, it should be considered in a dog with similar clinical findings. Clinical findings and results of appropriate diagnostic imaging procedures may provide valuable information in making this diagnosis and in planning surgical treatment.

摘要

病例描述

一只10岁未绝育的雌性犬因右侧胸壁腹外侧有一个持续15个月的静止、边界清晰的皮下肿块及相关的瘘管引流道而接受检查。

临床检查结果

计算机断层扫描(CT)和瘘管造影结果证实了瘘管的存在。CT还显示肝脏右腹侧有一个局灶性低密度区域,该区域与瘘管相邻但无明显关联。

治疗及结果

对瘘管进行手术探查发现,瘘管进入右半胸至膈肌;进入肝脏右内侧叶;并终止于一个包膜完整的囊性肝脏病变。切除了肝脏右内侧叶及所有受影响的组织。组织学检查显示,肝脏病变由一个纤维化、扩张的胆管组成。扩张的胆管和瘘管内衬胆管上皮。根据这些发现,诊断为自发性外部胆管瘘。术后5个月,该犬临床正常。

临床意义

据作者所知,兽医医学文献中尚未报道犬自发性外部胆管瘘。尽管这种情况罕见,但对于有类似临床症状的犬应予以考虑。临床症状及适当的诊断性影像学检查结果可为做出该诊断及规划手术治疗提供有价值的信息。

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