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犬双侧输尿管结石、肾积水、积脓、阴道积脓、前庭阴道狭窄及处女膜闭锁的诊断与手术治疗:一例罕见重症病例报告

Diagnosis and surgical treatment of bilateral ureteral calculi, hydronephrosis, pyometra, pyocolpos, vestibulovaginal stenosis, and imperforate hymen in a dog: A rare critical case report.

作者信息

Kim Sehoon, Rahman Md Mahbubur, Chul Park, Kim Minju, Jeong In Seong

机构信息

Department of Veterinary Surgery, Royal Animal Medical Center, Jungnang-gu, Seoul, Republic of Korea.

Research Center, KNOTUS Co., Ltd., Songdo-dong, Yeonsu-gu, Incheon, Republic of Korea.

出版信息

J Adv Vet Anim Res. 2020 Jun 29;7(3):384-390. doi: 10.5455/javar.2020.g432. eCollection 2020 Sep.

Abstract

OBJECTIVE

Bilateral ureteral calculi, hydronephrosis, pyometra, pyocolpos, vestibulovaginal stenosis, and imperforate hymen in a dog are uncommon and can be difficult to diagnose. The aim of this article is to report diagnostic challenges and successful surgical treatment of this rare event and the long-term outcomes.

MATERIALS AND METHODS

A 5-year-old, spayed (partial ovariohysterectomy) female dog was primarily diagnosed with bilateral hydronephrosis and ureter obstruction due to urolithiasis along with pyometra. The urolith was removed carefully by the right-side ureterectomy, an appropriate ureteral stent was inserted from the bladder to the right kidney, and then, a vasectomy and hysterectomy were performed. The dog improved and was discharged. However, 50 days after surgery, pyocolpos due to imperforate hymen and vestibulovaginal stenosis were diagnosed and surgically corrected, and the ureteral stent was removed because the ureter had completely healed.

RESULTS

During the first admission, serum biochemistry results revealed the increased blood urea nitrogen (5.9 mg/dl), creatinine (116.2 mg/dl), amylase (1,345 U/l), and lipase (141 U/l) values. After surgical correction, all parameters returned to normal. However, 50 days after surgery, the C-reactive protein concentration (143 mg/l) and white blood cell level increased (18.4 × 10/l). After a second surgical correction, the dog recovered fully within 10 days, and no postoperative complications were observed during the follow-up of 6 months.

CONCLUSION

This report provides diagnostic assistance and surgical treatment options for a complex urogenital case. Careful examination during puberty is recommended to prevent the associated complications of this disorder.

摘要

目的

犬双侧输尿管结石、肾积水、积脓、阴道积脓、前庭阴道狭窄及处女膜闭锁并不常见,且诊断困难。本文旨在报告这一罕见病例的诊断挑战、成功的手术治疗及长期预后。

材料与方法

一只5岁已绝育(部分卵巢子宫切除术)的雌性犬最初被诊断为双侧肾积水、因尿石症导致的输尿管梗阻以及积脓。通过右侧输尿管切除术小心取出尿石,从膀胱向右侧肾脏插入合适的输尿管支架,然后进行输精管切除术和子宫切除术。犬病情好转并出院。然而,术后50天,诊断出因处女膜闭锁和前庭阴道狭窄导致的阴道积脓,并进行了手术矫正,由于输尿管已完全愈合,取出了输尿管支架。

结果

首次入院时,血清生化结果显示血尿素氮(5.9mg/dl)、肌酐(116.2mg/dl)、淀粉酶(1345U/l)和脂肪酶(141U/l)值升高。手术矫正后,所有参数恢复正常。然而,术后50天,C反应蛋白浓度(143mg/l)和白细胞水平升高(18.4×10⁹/l)。二次手术矫正后,犬在10天内完全康复,随访6个月期间未观察到术后并发症。

结论

本报告为复杂泌尿生殖系统病例提供了诊断帮助和手术治疗选择。建议在青春期进行仔细检查,以预防该疾病的相关并发症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/969b/7521814/e5a727bd268f/JAVAR-7-384-g001.jpg

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