Cabon Quentin, Carmel Eric Norman, Cabassu Julien
From the VetAgroSup, Campus Vétérinaire de Lyon, Lyon, France (Q.C.); Department of Diagnostic Imaging, Centre Vétérinaire Laval, Québec, Canada (E.N.C.); and the Department of Surgery, Clinique Vétérinaire Cabassu, Marseille, France (J.C.).
J Am Anim Hosp Assoc. 2017 Sep/Oct;53(5):270-276. doi: 10.5326/JAAHA-MS-6457. Epub 2017 Aug 9.
A 4 mo old spayed female golden retriever was presented with a peritoneopericardial diaphragmatic hernia (PPDH) that was diagnosed during neutering. Echocardiography revealed a fluid-filled structure and parts of the liver in the pericardial cavity. Computed tomography confirmed the existence of the PPDH and the herniation of the right medial liver lobe and the gallbladder. Cystic masses were observed in the pericardial and the peritoneal cavities, possibly communicating through the PPDH. A median laparotomy revealed a single lobulated cystic lesion extending into both the pericardial and peritoneal cavities through the PPDH. Because of the nonviable aspect of some parts of the liver parenchyma, the gallbladder was dissected from the fossa, and the central division of the liver was resected. A cholecystopexy was performed on the diaphragm to limit gallbladder mobility. The PPDH was closed in the standard fashion. Histopathology of the cystic structure was compatible with a pericardial pseudocyst. Two months postoperatively, the dog was healthy, and the results of blood biochemistry and abdominal ultrasonography were normal. A pericardial pseudocyst can be associated with a PPDH in young dogs. Moreover, cholecystopexy appears to be a safe and effective method of limiting gallbladder mobility after resection of the central hepatic division.
一只4月龄已绝育的雌性金毛猎犬因在绝育手术中被诊断出患有腹膜心包膈疝(PPDH)前来就诊。超声心动图显示心包腔内有一个充满液体的结构以及部分肝脏。计算机断层扫描证实了PPDH的存在以及右内侧肝叶和胆囊的疝出。在心包腔和腹腔内观察到囊性肿物,可能通过PPDH相通。正中剖腹术显示一个单一的分叶状囊性病变通过PPDH延伸至心包腔和腹腔。由于部分肝实质无活力,将胆囊从胆囊窝分离,并切除肝脏中央部分。在膈肌上进行胆囊固定术以限制胆囊活动。以标准方式闭合PPDH。囊性结构的组织病理学检查结果与心包假性囊肿相符。术后两个月,该犬健康,血液生化和腹部超声检查结果正常。心包假性囊肿可能与幼犬的PPDH有关。此外,胆囊固定术似乎是一种在切除肝脏中央部分后限制胆囊活动的安全有效的方法。