Marquardt Shelly A, Rochat Mark C, Johnson-Neitman Jennifer L
Department of Veterinary Clinical Sciences, Oklahoma State University Center for Veterinary Health Sciences, Stillwater, OK, USA.
J Am Anim Hosp Assoc. 2012 Jan-Feb;48(1):43-9. doi: 10.5326/JAAHA-MS-715. Epub 2011 Dec 21.
The purpose of this case report was to describe the surgical correction of a cholecystocutaneous fistula in a dog. A 6 yr old Vizsla presented with a 2 mo history of a chronic draining wound on the right ventral thorax. Diagnostics revealed numerous fistulous tracts opening at a single site on the right ventrolateral chest wall, extending caudodorsally through the chest wall and diaphragm to the region of the right medial liver lobe. Exploratory laparotomy revealed the apex of the gallbladder adhered to the diaphragm with a tract of fibrous tissue extending along the diaphragm laterally to the right thoracic wall. Cholecystectomy was performed. The fistulous tract was incised to expose the lumen of the fistula, and the fistula was omentalized. Twenty-eight months after surgery, the dog had had no recurrence of the fistulous tract. Exploratory laparotomy allowed excellent visualization of the intra-abdominal path of the fistula and facilitated the ease of resection of the source. Cholecystectomy resulted in rapid and complete resolution of the fistula without the need for excision of the fistula. Although rare, gallbladder disease should be a differential for chronic fistulous tracts.
本病例报告的目的是描述一只犬胆囊皮肤瘘的手术矫正。一只6岁的维兹拉犬出现右侧腹胸部慢性引流伤口2个月的病史。诊断显示在右侧胸壁腹外侧的单个部位有许多瘘管开口,从胸壁向背尾侧延伸穿过胸壁和膈肌至右内侧肝叶区域。剖腹探查发现胆囊顶端与膈肌粘连,有一束纤维组织沿膈肌向外侧延伸至右胸壁。进行了胆囊切除术。切开瘘管以暴露瘘管腔,并用网膜覆盖瘘管。术后28个月,该犬瘘管未复发。剖腹探查能很好地观察瘘管在腹腔内的路径,并便于轻松切除源头。胆囊切除术使瘘管迅速完全愈合,无需切除瘘管。虽然罕见,但胆囊疾病应作为慢性瘘管的鉴别诊断。