Brückner Michael
J Am Vet Med Assoc. 2019 Jul 15;255(2):213-218. doi: 10.2460/javma.255.2.213.
A 15-year-old spayed female domestic shorthair cat was examined because of a 1-year history of daily vomiting, which was not associated with food intake. Initial physical examination findings and serial hematologic and serum biochemical results were unremarkable except for the presence of a grade 2/6 left-sided heart murmur and persistent mild azotemia. A well-defined multilobulated cystic structure located between the spleen and left kidney was identified by abdominal ultrasonography. Laparoscopic exploration revealed that the cystic structure originated from the left pancreatic limb. With laparoscopic guidance, the structure was percutaneously drained and underwent omentalization. Then, a partial cystectomy was performed to obtain a tissue specimen for histologic evaluation. The vomiting resolved for a short period immediately after surgery and then gradually resumed over 6 months, albeit with less frequency than prior to surgery. The histologic diagnosis was pancreatic cyst. Abdominal ultrasonography performed 6 months after surgery revealed that the original cyst had completely resolved but multiple smaller cysts had developed. The serum feline pancreas-specific lipase activity was not measured before surgery but remained increased from the reference limit following surgery, and chronic pancreatitis was considered the most likely cause of pancreatic cyst formation. Laparoscopic-guided drainage and omentalization of a large pancreatic cyst resulted in a satisfactory outcome for the cat of this report and can be considered an alternative to percutaneous ultrasound-guided cyst drainage and the more invasive laparotomy approach for pancreatic cystectomy with or without omentalization.
一只15岁已绝育的雌性家养短毛猫因有1年每日呕吐史前来就诊,呕吐与进食无关。初次体格检查结果以及系列血液学和血清生化检查结果均无异常,仅存在2/6级左侧心脏杂音和持续性轻度氮质血症。腹部超声检查发现脾脏和左肾之间有一个边界清晰的多叶囊性结构。腹腔镜探查显示该囊性结构起源于左胰腺分支。在腹腔镜引导下,该结构经皮引流并进行了网膜包裹术。然后,进行了部分囊肿切除术以获取组织标本进行组织学评估。术后呕吐立即短暂缓解,随后在6个月内逐渐恢复,尽管频率低于手术前。组织学诊断为胰腺囊肿。术后6个月进行的腹部超声检查显示,原来的囊肿已完全消失,但出现了多个较小的囊肿。术前未检测血清猫胰腺特异性脂肪酶活性,但术后仍高于参考值上限,慢性胰腺炎被认为是胰腺囊肿形成的最可能原因。本报告中的猫经腹腔镜引导下对大的胰腺囊肿进行引流和网膜包裹术取得了满意的效果,可被视为经皮超声引导下囊肿引流以及更具侵入性的剖腹手术进行胰腺囊肿切除(无论是否进行网膜包裹术)的替代方法。