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犬无黄疸性胆囊破裂:5例(2007 - 2013年)

Anicteric gallbladder rupture in dogs: 5 cases (2007-2013).

作者信息

Guess Sarah C, Harkin Kenneth R, Biller David S

出版信息

J Am Vet Med Assoc. 2015 Dec 15;247(12):1412-4. doi: 10.2460/javma.247.12.1412.

Abstract

OBJECTIVE

To describe clinical, laboratory, and surgical findings in dogs with confirmed gallbladder rupture and in which serum total bilirubin concentration was within reference limits.

DESIGN

Retrospective case series.

ANIMALS

5 dogs.

PROCEDURES

Medical records were searched to identify dogs with gallbladder rupture that underwent treatment at the Kansas State University Veterinary Health Center from November 2007 through November 2013. Dogs were included if they had undergone abdominal ultrasonography, serum total bilirubin concentration was ≤ 0.4 mg/dL, and abdominal exploratory surgery confirmed the presence of gallbladder upture.

RESULTS

An exploratory celotomy was performed in all dogs because of ultrasonographic findings of mild to marked abdominal effusion and either an unidentifiable gallbladder (n = 1 dog) or a distended gallbladder with a suspected gallbladder mucocele (4 dogs). Serum total bilirubin concentration was within reference limits (median, 0.2 mg/dL; range, 0.1 to 0.4 mg/dL; reference range, 0.1 to 0.4 mg/dL) in all dogs before surgery. In 1 dog, bile acids concentrations in serum and in peritoneal fluid were compared and the results (48 μmol/L and 1,070 μmol/L, respectively) were supportive of the diagnosis of gallbladder rupture.

CONCLUSIONS AND CLINICAL RELEVANCE

Results indicated that even when serum total bilirubin concentration is within reference limits, gallbladder rupture should be considered in dogs with acute signs of abdominal pain when a mucocele is suspected on abdominal imaging and free abdominal fluid is present. Results suggested that a comparison of serum to peritoneal fluid bile acids concentrations may provide additional support for a diagnosis of gallbladder rupture.

摘要

目的

描述确诊胆囊破裂且血清总胆红素浓度在参考范围内的犬的临床、实验室及手术检查结果。

设计

回顾性病例系列研究。

动物

5只犬。

方法

检索堪萨斯州立大学兽医健康中心2007年11月至2013年11月期间接受治疗的胆囊破裂犬的病历。纳入标准为接受过腹部超声检查、血清总胆红素浓度≤0.4mg/dL且腹部探查手术证实存在胆囊破裂的犬。

结果

由于超声检查发现轻度至重度腹腔积液以及无法识别的胆囊(1只犬)或胆囊扩张伴疑似胆囊黏液囊肿(4只犬),所有犬均接受了剖腹探查术。所有犬术前血清总胆红素浓度均在参考范围内(中位数,0.2mg/dL;范围,0.1至0.4mg/dL;参考范围,0.1至0.4mg/dL)。对1只犬的血清和腹腔积液中的胆汁酸浓度进行了比较,结果(分别为48μmol/L和1070μmol/L)支持胆囊破裂的诊断。

结论及临床意义

结果表明,即使血清总胆红素浓度在参考范围内,当腹部影像学怀疑有黏液囊肿且存在腹腔游离液体时,有急性腹痛症状的犬也应考虑胆囊破裂。结果提示,血清与腹腔积液胆汁酸浓度的比较可能为胆囊破裂的诊断提供额外支持。

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