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犬胆结石:29例(1980 - 1990年)

Cholelithiasis in dogs: 29 cases (1980-1990).

作者信息

Kirpensteijn J, Fingland R B, Ulrich T, Sikkema D A, Allen S W

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan 66502.

出版信息

J Am Vet Med Assoc. 1993 Apr 1;202(7):1137-42.

PMID:8473231
Abstract

Medical records of 29 dogs with cholelithiasis were reviewed. Aged female small-breed dogs were overrepresented. Mean age was 9.5 years, and mean weight was 12 kg. Vomiting, anorexia, weakness, polyuria/polydipsia, weight loss, icterus, fever, and signs of abdominal pain were the most common clinical signs. Leukocytosis, neutrophilia with left shift, monocytosis, high activity of serum hepatic enzymes, hypoalbuminemia, and high concentrations of serum total bilirubin were common. Radiopaque choleliths were evident on abdominal radiography of 13 of 27 dogs. Microbial culturing of bile isolated organisms in 15 of 20 dogs. Gram-negative bacteria were most common. Surgery was performed in 22 dogs. Four dogs were treated medically, and 3 dogs were euthanatized without treatment. Surgical treatment consisted of cholecystectomy in 11 dogs, choledochotomy in 5 dogs, cholecystotomy in 4 dogs, and cholecystojejunostomy in 1 dog. Sphincter of Oddiotomy was performed in 1 dog. Five dogs had concurrent generalized peritonitis attributable to bile. Multiple choleliths were detected in most of the dogs. Choleliths were located in the gallbladder in 20 dogs and in the bile ducts in 14 dogs. The most common abnormalities of the gallbladder, identified histologically, were chronic cholecystitis, mucosal hyperplasia, and pericholecystic inflammation. The most common abnormalities of the liver were cholestasis, hepatocellular degeneration, and periportal fibrosis. Survival rate of dogs that underwent cholecystectomy tended to be higher (86%) than that of dogs treated via cholecystotomy (50%) or cholecystectomy in combination with choledochotomy (33%). Dogs that underwent medical treatment, abdominal exploratory, cholecystojenunostomy, choledochotomy, and sphincter of Oddiotomy died or were euthanatized because of redevelopment of clinical signs associated with cholelithiasis.(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

回顾了29只患有胆结石的犬的病历。老龄雌性小型犬占比过高。平均年龄为9.5岁,平均体重为12千克。呕吐、厌食、虚弱、多尿/多饮、体重减轻、黄疸、发热和腹痛症状是最常见的临床体征。白细胞增多、核左移的中性粒细胞增多、单核细胞增多、血清肝酶活性升高、低白蛋白血症以及血清总胆红素浓度升高很常见。27只犬中的13只腹部X线片显示不透射线的胆结石。20只犬中的15只胆汁微生物培养分离出了微生物。革兰氏阴性菌最为常见。22只犬接受了手术治疗。4只犬接受药物治疗,3只犬未经治疗实施了安乐死。手术治疗包括11只犬行胆囊切除术,5只犬行胆总管切开术,4只犬行胆囊切开术,1只犬行胆囊空肠吻合术。1只犬行奥迪括约肌切开术。5只犬并发胆汁性全身性腹膜炎。大多数犬检测到多个胆结石。20只犬的胆结石位于胆囊,14只犬的位于胆管。组织学鉴定的胆囊最常见异常为慢性胆囊炎、黏膜增生和胆囊周围炎症。肝脏最常见异常为胆汁淤积、肝细胞变性和门周纤维化。接受胆囊切除术的犬的存活率(86%)往往高于接受胆囊切开术(50%)或胆囊切除术联合胆总管切开术(33%)的犬。接受药物治疗、腹部探查、胆囊空肠吻合术、胆总管切开术和奥迪括约肌切开术的犬因胆结石相关临床症状复发而死亡或实施安乐死。(摘要截断于250字)

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