J Am Anim Hosp Assoc. 2021 Sep 1;57(5):247-251. doi: 10.5326/JAAHA-MS-7090.
An 11 mo old domestic shorthair presented with acute lethargy. The cat was hypothermic and bradycardic and had pale pink mucous membranes, poor pulses, and a distended abdomen. Point-of-care ultrasound identified significant abdominal effusion, which was diagnosed to be a hemoabdomen. Bloodwork revealed hyperlactatemia, regenerative anemia, neutrophilia, hypoproteinemia, hypoalbuminemia, and increased alanine aminotransferase. The cat received an allotransfusion and a subsequent canine xenotransfusion and received further supportive therapy. After stabilization, abdominal ultrasonography diagnosed a gallbladder and liver lobe torsion with hemoabdomen. Exploratory laparotomy confirmed the torsion of the right medial and quadrate hepatic lobes together with the gallbladder. Cholecystectomy and lobectomy of the affected lobes were performed using a surgical stapler. The cat was discharged after 4 days. Histopathology confirmed hemorrhagic infarction of the liver lobes and gallbladder, consistent with the described torsion, and the hepatic pseudocyst. It also demonstrated a mucocele in the gallbladder. One month postoperatively, the cat had totally recovered. Hepatic lobe torsion without neoplasia is a rare disease in cats, with variable clinical signs. Gallbladder torsion is a hitherto unreported condition in cats. This is the first report of gallbladder and liver lobe torsion with secondary hemoabdomen in a cat, successfully treated by one-stage surgery.
一只 11 个月大的家养短毛猫出现急性嗜睡。这只猫体温过低且心动过缓,黏膜呈淡粉色,脉搏微弱,腹部膨胀。即时护理超声检查发现大量腹水,诊断为血腹。血液检查显示高乳酸血症、再生性贫血、中性粒细胞增多、低蛋白血症、低白蛋白血症和丙氨酸氨基转移酶升高。这只猫接受了同种异体输血和随后的犬异种输血,并接受了进一步的支持治疗。稳定后,腹部超声检查诊断出胆囊和肝叶扭转伴血腹。剖腹探查证实了右内侧和四边形肝叶与胆囊的扭转。使用外科吻合器进行了胆囊切除术和受影响肝叶的部分肝叶切除术。这只猫在 4 天后出院。组织病理学证实了肝叶和胆囊的出血性梗死,与描述的扭转一致,还有肝假性囊肿。还在胆囊中发现了黏液囊肿。术后 1 个月,这只猫已完全康复。无肿瘤的肝叶扭转在猫中是一种罕见疾病,其临床症状多样。胆囊扭转在猫中是一种尚未报道的情况。这是首例猫胆囊和肝叶扭转伴继发性血腹的病例,通过一期手术成功治疗。