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病例报告:犬胃内结晶性异物碎片所致壁内胃脓肿合并幽门梗阻的手术治疗

Case report: Surgical treatment of pyloric obstruction with intramural gastric abscess induced by fragmented crystalline foreign materials in a dog.

作者信息

Kim Jihun, Son Hyunglak, Lee Sungin

机构信息

Department of Veterinary Surgery, College of Veterinary Medicine, Chungbuk National University, Cheongju, Republic of Korea.

Department of Veterinary Surgery, Haemaru Referral Hospital, Seongnam, Republic of Korea.

出版信息

Front Vet Sci. 2024 Aug 7;11:1427218. doi: 10.3389/fvets.2024.1427218. eCollection 2024.

DOI:10.3389/fvets.2024.1427218
PMID:39170636
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11335634/
Abstract

An 11-year-old neutered male Maltese presented with a 2-day history of persistent vomiting and lethargy. Abdominal ultrasonography revealed a hypoechoic marginal mass with gastric wall thickening in the pyloric region of the stomach. Computed tomography revealed a non-contrast-enhanced mass in the pyloric antrum causing pyloric outflow obstruction. Imaging studies suggested a tumor and surgical treatment was performed due to the deterioration of the patient's condition. The pyloric mass was excised, and the stomach and duodenum were anastomosed via pylorectomy and gastroduodenostomy (Billroth I procedure). Postoperatively, the pyloric outflow obstruction resolved, clinical symptoms improved, and no significant complications were observed. Histopathological examination revealed a gastric abscess characterized by a mass-like area with abundant necrosis. Angular fragmented crystalline foreign materials were observed within the lesion. To our knowledge, this is the first reported case of an intramural gastric abscess caused by fragmented crystalline foreign materials in a dog. Although rare, this case highlights the importance of considering gastric abscesses in the differential diagnoses of gastric masses. If the cause of the gastric abscess is an invisible foreign material, postoperative follow-up should be considered to monitor for potential recurrence.

摘要

一只11岁已绝育的雄性马尔济斯犬出现持续呕吐和嗜睡2天的症状。腹部超声检查显示胃幽门区有一个低回声边缘性肿块,胃壁增厚。计算机断层扫描显示幽门窦有一个无强化肿块,导致幽门流出道梗阻。影像学检查提示为肿瘤,由于患者病情恶化,遂进行了手术治疗。切除幽门肿块,通过幽门切除术和胃十二指肠吻合术(毕罗一式手术)将胃和十二指肠进行吻合。术后,幽门流出道梗阻解除,临床症状改善,未观察到明显并发症。组织病理学检查显示为胃脓肿,其特征为有大量坏死的肿块样区域。在病变内观察到有角状破碎晶体异物。据我们所知,这是首例报道的犬因破碎晶体异物引起的壁内胃脓肿病例。尽管罕见,但该病例凸显了在胃肿块鉴别诊断中考虑胃脓肿的重要性。如果胃脓肿的病因是不可见的异物,则应考虑术后随访以监测潜在复发情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/000a/11335634/7fc2794b5802/fvets-11-1427218-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/000a/11335634/85d60d1d988d/fvets-11-1427218-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/000a/11335634/c73a6757aac6/fvets-11-1427218-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/000a/11335634/86750cf6e700/fvets-11-1427218-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/000a/11335634/7fc2794b5802/fvets-11-1427218-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/000a/11335634/85d60d1d988d/fvets-11-1427218-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/000a/11335634/c73a6757aac6/fvets-11-1427218-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/000a/11335634/86750cf6e700/fvets-11-1427218-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/000a/11335634/7fc2794b5802/fvets-11-1427218-g004.jpg

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本文引用的文献

1
Intramural gastric abscesses in a dog.犬胃壁脓肿。
J Small Anim Pract. 2024 Jul;65(7):596-600. doi: 10.1111/jsap.13713. Epub 2024 Mar 5.
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Intramural Gastric Abscess Misdiagnosed as Advanced Gastric Cancer.胃壁内脓肿被误诊为晚期胃癌。
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Comparison of the clinical, ultrasound, and CT findings in 13 dogs with gastric neoplasia.比较 13 例患有胃肿瘤犬的临床、超声和 CT 检查结果。
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J Vet Cardiol. 2019 Jun;23:122-128. doi: 10.1016/j.jvc.2019.03.001. Epub 2019 Apr 30.
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Diagnostic challenges in differentiating intramural gastric abscess from gastric cancer: Two case reports.鉴别壁内胃脓肿与胃癌的诊断挑战:两例病例报告
Medicine (Baltimore). 2018 Oct;97(43):e12756. doi: 10.1097/MD.0000000000012756.
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