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[一匹患腹痛症的小马的盲肠胃肠道间质瘤]

[A gastrointestinal stromal tumour of the caecum in a pony with colic].

作者信息

Rapp M, Schmitz R R, Meyer A, Mundhenk L, Gehlen H

机构信息

Maike Rapp, Klinik für Pferde, Allgemeine Chirurgie und Radiologie, Fachbereich Veterinärmedizin, Freie Universität Berlin, Oertzenweg 19b, 14163 Berlin, E-Mail:

出版信息

Tierarztl Prax Ausg G Grosstiere Nutztiere. 2014;42(5):305-10.

Abstract

A 25-year-old pony mare was presented to the clinic with preliminarily reported severe acute colic. The pony during the previous week had shown inappetence, apathy and fever of unknown origin. Clinical examination and placement of a gastric tube were indicative of a secondary gastric dilation. Rectal exploration found moderate caecal meteorism with a tensed and painful medial taenia as well as a dilated and fluid-filled small intestine. In addition, a solid, mobile, non-painful structure of approximately 10 cm diameter was palpated ventrally. A hyperechogenic mass close to the caecum was detected using ultrasonography of the abdomen in the right flank. The peritoneal fluid was an exudate with cytological signs of an acute to subacute peritonitis. Blood analysis showed markedly increased plasma lactate concentration and a marginal neutrophilia and lymphopenia, with a total leukocyte count of 6 G/l. Because the owners refused consent for a laparotomy and the pony showed increased signs of severe pain despite conservative medical treatment, it was euthanized. The main findings on necropsy were extensive adherence of the caecal apex to the right and left colon and the ileum as well as a neoplasia in the lumen of the caecal apex. The mass, which was covered with a mucous membrane, had a tough consistency. The cut surface was grey-white to beige-coloured and multilobular with numerous necrotic and acute haemorrhagic areas. According to histopathological and immunohistochemical findings, the mass was characterized as a gastrointestinal stromal tumour (GIST), a rare neoplasia in horses.

摘要

一匹25岁的母马被送至诊所,初步诊断为严重急性腹痛。这匹母马在前一周出现食欲不振、精神萎靡和不明原因发热。临床检查及放置胃管显示为继发性胃扩张。直肠探查发现盲肠中度积气,内侧结肠带紧张且疼痛,小肠扩张并充满液体。此外,在腹侧触诊到一个直径约10厘米、质地坚硬、可移动且无压痛的结构。通过右侧腹超声检查发现靠近盲肠处有一个高回声团块。腹腔积液为渗出液,有急性至亚急性腹膜炎的细胞学迹象。血液分析显示血浆乳酸浓度显著升高,轻度中性粒细胞增多和淋巴细胞减少,白细胞总数为6 G/l。由于主人拒绝同意进行剖腹手术,且尽管进行了保守药物治疗,这匹母马的剧痛症状仍加剧,最终对其实施了安乐死。尸检的主要发现是盲肠尖端与左右结肠及回肠广泛粘连,以及盲肠尖端腔内有肿瘤形成。该肿块表面覆盖有黏膜,质地坚韧。切面呈灰白色至米色,多叶状,有许多坏死和急性出血区域。根据组织病理学和免疫组织化学检查结果,该肿块被确诊为胃肠道间质瘤(GIST),这是一种马类罕见的肿瘤。

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