Krentz Terence A, Schutrumpf Robert J, Zitz Julie C
J Am Vet Med Assoc. 2017 Jul 15;251(2):201-205. doi: 10.2460/javma.251.2.201.
CASE DESCRIPTION A 1-year-old castrated male German Shepherd Dog was examined because of an acute onset of lethargy, tachypnea, and inappetence. CLINICAL FINDINGS On initial physical examination, the dog was tachypneic with muffled heart sounds on thoracic auscultation and a palpable abdominal fluid wave. Transthoracic echocardiography revealed focal intramural pericardial effusion and cardiac tamponade. TREATMENT AND OUTCOME The patient underwent emergency therapeutic pericardiocentesis, followed by right lateral intercostal thoracotomy and subtotal pericardiectomy. A 3 × 5-cm mass located between the parietal and visceral layers of the pericardium was resected. The histologic diagnosis was necrotic adipose tissue with granulomatous inflammation and fibroplasia. The patient also underwent exploratory laparotomy and umbilical herniorrhaphy during the same anesthetic episode and recovered from surgery without apparent complications. There were no further clinical signs of cardiac disease. CLINICAL RELEVANCE The patient described in the present report underwent successful subtotal pericardiectomy for treatment of a benign focal lesion causing recurrent pericardial effusion and cardiac tamponade. Prompt diagnosis and intervention may have contributed to the positive outcome in this case.
病例描述 一只1岁去势雄性德国牧羊犬因突然出现嗜睡、呼吸急促和食欲不振而接受检查。临床发现 初次体格检查时，该犬呼吸急促，胸部听诊心音低沉，可触及腹部液波。经胸超声心动图显示局灶性壁内心包积液和心脏压塞。治疗与结果 患者接受了紧急治疗性心包穿刺术，随后进行右侧肋间开胸和心包次全切除术。切除了位于心包脏层和壁层之间的一个3×5厘米的肿块。组织学诊断为坏死性脂肪组织伴肉芽肿性炎症和纤维增生。患者在同一次麻醉过程中还接受了剖腹探查术和脐疝修补术，术后恢复良好，无明显并发症。未再出现心脏病的临床症状。临床意义 本报告中描述的患者因良性局灶性病变导致复发性心包积液和心脏压塞，接受心包次全切除术成功。及时诊断和干预可能是该病例取得良好结果的原因。
