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犬疑似心包金属弹丸异物的诊断挑战与治疗选择

Diagnostic challenges and treatment options of a suspected pericardial metallic projectile foreign body in a dog.

作者信息

Elliott Joshua M, Mayhew Philipp D

机构信息

From the Department of Small Animal Surgery, University of California-Davis, School of Veterinary Medicine, Davis, CA 95616, USA.

出版信息

J Vet Emerg Crit Care (San Antonio). 2011 Dec;21(6):684-91. doi: 10.1111/j.1476-4431.2011.00690.x. Epub 2011 Nov 21.

Abstract

OBJECTIVE

To describe a case of a suspected pericardial metallic projectile foreign body in a dog with a history of trauma to the left shoulder and to review the literature regarding the management of cardiac and intracardiac foreign bodies.

CASE SUMMARY

A 3-year-old male, neutered Brittany spaniel presented with a 10-day history of decreased activity and partial anorexia. Serial thoracic radiographs identified a migrating pericardial metallic projectile foreign body and an echocardiogram diagnosed pericardial effusion and abdominal ultrasound identified the presence of ascites. Concern for a possible effusive-constrictive pericarditis prompted a subphrenic pericardectomy performed via thoracoscopy. The foreign body was not recovered. Six months postsurgery, the dog remained asymptomatic.

NEW OR UNIQUE INFORMATION PROVIDED

Considering the high rate of complications that develop in human patients where the foreign bodies are not removed, veterinarians should be aware of risks associated with long standing pericardial foreign bodies even when no clinical signs are present. Guidelines from the human literature may be considered for investigation of, and treatment options for, cardiac and intracardiac metallic projectile foreign bodies in dogs.

摘要

目的

描述一例有左肩外伤史的犬疑似心包金属弹片异物病例,并回顾有关心脏及心内异物处理的文献。

病例摘要

一只3岁已绝育的不列塔尼猎犬出现活动减少和部分厌食10天的病史。系列胸部X线片发现一枚游走于心包的金属弹片异物,超声心动图诊断有心包积液,腹部超声检查发现存在腹水。因担心可能发生渗出性缩窄性心包炎,遂通过胸腔镜进行膈下心包切除术。异物未取出。术后6个月,该犬仍无症状。

提供的新的或独特信息

考虑到在人类患者中异物未取出时并发症发生率较高,兽医应意识到即使没有临床症状,长期存在的心包异物也存在相关风险。对于犬心脏及心内金属弹片异物的检查和治疗选择,可考虑参考人类文献中的指南。

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