Crews Laura J, Feeney Daniel A, Jessen Carl R, Rose Nathan D, Matise Ilze
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA.
J Am Vet Med Assoc. 2009 Feb 1;234(3):359-66. doi: 10.2460/javma.234.3.359.
To identify clinical, laboratory, and ultrasonographic characteristics associated with gallbladder disease and rupture in dogs.
Retrospective case series.
45 client-owned dogs.
Medical records of dogs with histologically confirmed gallbladder disease that had ultrasonographic evaluation were reviewed. Signalment, history, clinical signs, laboratory values, bacteriologic culture of bile, gallbladder status at surgery or necropsy (intact vs ruptured), histopathologic findings, radiographic findings, ultrasonographic findings, and outcome were analyzed.
The most common ultrasonographic findings were echogenic peritoneal fluid, thickened or laminated gallbladder wall, and echogenic reaction in the gallbladder fossa. Eighteen of 45 (40%) dogs had gallbladder rupture. Rupture was associated with histologic evidence of gallbladder necrosis, decreased serosal detail radiographically, and pericholecystic echogenic reaction, pericholecystic echogenic fluid, and generalized echogenic abdominal effusion ultrasonographically. Twenty-one of 45 (47%) dogs had mucocele, and 9 (43%) of those had gallbladder rupture. Eleven of 40 dogs had positive results of bacteriologic culture, and 5 of those had gallbladder rupture. Only 2 dogs had concurrent positive results of bacterial bile culture and gallbladder mucocele. Survival rate was 86% and not significantly related to presurgical bile leakage, positive results of bacterial culture, or mucocele.
Ultrasonographic findings of pericholecystic reaction, localized or generalized echogenic peritoneal fluid, or decreased radiographic peritoneal detail should raise the index of suspicion for gallbladder rupture. Mucocele or bacterial gallbladder infection was the most common concurrent finding in dogs with gallbladder rupture.
确定与犬胆囊疾病及破裂相关的临床、实验室和超声特征。
回顾性病例系列研究。
45只客户拥有的犬。
对经组织学确诊患有胆囊疾病且接受过超声评估的犬的病历进行回顾。分析品种、病史、临床症状、实验室检查值、胆汁细菌培养结果、手术或尸检时胆囊状况（完整或破裂）、组织病理学检查结果、放射学检查结果、超声检查结果及转归。
最常见的超声检查结果为腹腔内有回声液性暗区、胆囊壁增厚或分层、胆囊窝内有回声反应。45只犬中有18只（40%）发生胆囊破裂。破裂与胆囊坏死的组织学证据、放射学检查时浆膜细节减少以及超声检查时胆囊周围有回声反应、胆囊周围有回声液性暗区和腹腔内广泛有回声积液有关。45只犬中有21只（47%）患有胆囊黏液囊肿，其中9只（43%）发生胆囊破裂。40只犬中有11只胆汁细菌培养结果为阳性，其中5只发生胆囊破裂。仅2只犬胆汁细菌培养和胆囊黏液囊肿同时呈阳性。生存率为86%，与术前胆汁漏、细菌培养阳性结果或黏液囊肿无显著相关性。
胆囊周围反应、局限性或广泛性腹腔内有回声液性暗区的超声检查结果或放射学检查时腹腔细节减少应提高对胆囊破裂的怀疑指数。黏液囊肿或细菌性胆囊感染是胆囊破裂犬最常见的并发情况。
