Department of Clinical Veterinary Science, Division of Companion Animals, University of Bristol, Langford, Bristol BS40 5DU, UK.
J Vet Intern Med. 2010 Jan-Feb;24(1):80-3. doi: 10.1111/j.1939-1676.2009.0427.x.
In the investigations of dogs with chronic small intestinal diarrhea collection of ileal biopsies lengthens procedural time and has been of uncertain value.
To evaluate whether there was agreement between histologic changes present in samples of duodenal and ileal mucosa, and hence to provide initial information in the process of determining whether collection of ileal biopsies is clinically justified.
40 dogs with chronic small and large intestinal diarrhea from which endoscopic (in 30 cases) or surgical (in 10 cases) duodenal and ileal biopsies had been collected.
Samples were reviewed concurrently by two observers (MJD and MDW) using the scoring system developed by the World Small Animal Veterinary Association (WSAVA) Gastrointestinal Standardization Group. Comparisons were made by kappa analysis.
Microscopic pathology was observed in 30 cases. Only eight out of this 30 (27%) had the same histopathologic diagnosis in both the duodenum and the ileum. This dropped to 3 out of 30 (10%) if different disease severity was also considered as disagreement. Microscopic pathology would have been found in 60% and 80% of the 30 cases, if only duodenal or ileal biopsies respectively, had been available.
There was poor agreement between histopathological findings from duodenal versus ileal biopsies with abnormalities sometimes being more readily detected in the ileum. Routine collection of ileal plus duodenal samples appears warranted when concurrent small and large intestinal diarrhea is present.
在患有慢性小肠腹泻的犬只的研究中,采集回肠活检样本会延长操作时间,而且其价值也不确定。
评估十二指肠和回肠黏膜样本中存在的组织学变化是否一致,从而为确定是否有必要进行回肠活检提供初步信息。
40 只患有慢性小肠和大肠腹泻的犬,这些犬通过内镜(30 例)或手术(10 例)采集了十二指肠和回肠活检样本。
由两位观察者(MJD 和 MDW)使用世界小动物兽医协会(WSAVA)胃肠道标准化小组制定的评分系统同时对样本进行评估。通过kappa 分析进行比较。
30 例中有 30 例观察到显微镜下的病理变化。这 30 例中只有 8 例(27%)在十二指肠和回肠都有相同的组织病理学诊断。如果还考虑不同的疾病严重程度,则有 3 例(10%)不一致。如果只进行十二指肠或回肠活检,那么 30 例中的 60%和 80%会发现显微镜下的病理变化。
十二指肠与回肠活检的组织病理学发现之间的一致性较差,回肠中有时更容易发现异常。当同时存在小肠和大肠腹泻时,有必要常规采集回肠加十二指肠样本。