Rheingold Curtis G, Dickens Cody, Tran Anna, Hess Rebecka S, Buriko Yekaterina
J Am Vet Med Assoc. 2024 Aug 28;263(3):343-350. doi: 10.2460/javma.24.04.0271. Print 2025 Mar 1.
To evaluate whether abdominal ultrasound correctly diagnosed septic peritonitis and correctly identified its causative lesion in dogs and cats.
84 client-owned dogs and 10 cats that underwent an abdominal ultrasound and had confirmation of septic peritonitis via exploratory laparotomy or necropsy.
This retrospective case series documented abdominal ultrasound findings, surgical or necropsy findings, and method for initial diagnosis of septic peritonitis, if different from surgery or necropsy. The surgical report and necropsy findings were compared to sonography results to confirm a diagnosis of septic peritonitis. The frequency at which sonography diagnosed septic peritonitis and its causative lesion was calculated for each type of lesion pathology and organ system. Secondary aims included evaluating the effect of patient characteristics (body weight and species) on sonographic results and whether lesion type or location affected mortality.
Most lesions causing septic peritonitis (70.2%) were gastrointestinal in origin and were nonneoplastic ulcerations or perforations (50%). Abdominal ultrasound diagnosed 56.3% of cases of subsequently confirmed septic peritonitis and correctly identified 67% of the causative lesions. Lesions of the gastrointestinal tract and ulcerations/perforations were the most frequent correct sonographic diagnoses and most likely to lead to a correct sonographic diagnosis of septic peritonitis. Lesions located in the hepatobiliary system and lesion types other than neoplasia or ulcerations/perforations were the most frequently missed by abdominal ultrasound.
Abdominal ultrasound often fails to diagnose septic peritonitis or the underlying causative lesion, and its accuracy depends on the affected organ and type of lesion.
评估腹部超声能否正确诊断犬猫的化脓性腹膜炎，并正确识别其病因性病变。
84只客户拥有的犬和10只猫，这些动物接受了腹部超声检查，并通过剖腹探查术或尸检确诊为化脓性腹膜炎。
本回顾性病例系列记录了腹部超声检查结果、手术或尸检结果，以及化脓性腹膜炎的初始诊断方法（如果与手术或尸检不同）。将手术报告和尸检结果与超声检查结果进行比较，以确诊化脓性腹膜炎。计算每种病变病理类型和器官系统中超声诊断化脓性腹膜炎及其病因性病变的频率。次要目的包括评估患者特征（体重和物种）对超声检查结果的影响，以及病变类型或位置是否影响死亡率。
大多数引起化脓性腹膜炎的病变（70.2%）起源于胃肠道，是非肿瘤性溃疡或穿孔（50%）。腹部超声诊断出56.3%随后确诊的化脓性腹膜炎病例，并正确识别了67%的病因性病变。胃肠道病变和溃疡/穿孔是最常见的正确超声诊断，也是最有可能导致化脓性腹膜炎正确超声诊断的病变。位于肝胆系统的病变以及肿瘤或溃疡/穿孔以外的病变类型是腹部超声最常漏诊的。
腹部超声常常无法诊断化脓性腹膜炎或潜在的病因性病变，其准确性取决于受影响的器官和病变类型。
