Bir Köpekte Kistik Müsinöz Safra Kesesinin Klinik, Ultrasonografik ve Patolojik Değerlendirilmesi

Öz

Bu olgunun materyalini, uyuşukluk, polipne ve abdominal distensiyon şikayetiyle hayvan hastanesine getirilen 11 yaşlı erkek bir Spaniel Cocker oluşturdu. Fiziksel muayenede; karında hassasiyet tespit edildi. Vücut ısısı ve nabız sayısı fizyolojik seviyelerde ölçüldü. Ultrasonografik muayenede; hepatomegali, kalınlaşmış ve genişlemiş safra kesesi tespit edildi. Safra kesesi lümeninde hiperekoik içerik, ayrıca batında az miktarda serbest sıvı görüldü. Safra kesesi duvar kalınlığı 3,5 mm olarak ölçüldü. Biyokimyasal incelemede; AST, ALP, GGT ve toplam kolesterol seviyeleri önemli ölçüde artmış olarak tespit edildi. AST, glikoz ve fosfor seviyeleri referans değerlerin biraz üzerindeydi. Yapılan sağaltıma karşın hasta bir hafta sonra öldü ve nekropsi uygulandı. Bu olgu sunumunda bir köpekte rastlanılan kistik müsinöz safra kesesinin klinik, ultrasonografik ve patolojik değerlendirilmesi amaçlanmıştır.

Anahtar Kelimeler

• Kistik müsinöz safra kesesi
• Köpek
• Ultrasonografi

Clinical, Ultrasonographic and Pathologic Evaluation of Cystic Mucinous Gallbladder in a Dog

Öz

An 11 years old male Spaniel Cocker was handled to Animal Hospital with lethargy, polypnea and abdominal distension. At physical examination; abdominal sensitivity was detected. The body temperature and heart rate were measured in physiological levels. On ultrasonographic examination; hepatomegaly, thickened and enlarged gallbladder were detected. Hyperechoic content in the lumen was observed also mild free liquid was seen in the abdomen. Gall bladder wall thickness was measured as 3,5 mm. At biochemical examination; AST, ALP, GGT and total cholesterol levels were significantly increased and AST, glucose and phosphorus levels were slightly increased when compared with the reference values. Due to treatment, the patient died after a week and necropsy was performed. At the pathologic examination; cystic mucinous gallbladder was detected. In this case presentation, clinical, ultrasonographic and pathologic evaluation of cystic mucinous gallbladder in a dog was described.

Anahtar Kelimeler

• Cystic mucinous gallbladder
• Dog
• Ultrasonography

Kaynakça

1. Bandyopadhyay S, Varshney JP, Hoque M, Sarkar M, Ghosh MK. Prevalence of cholecystic diseases in dogs: an ultrasonographic evaluation. Asian J Anim Vet Adv 2007; 2 (4): 234–238.
2. Bernhoft RA, Pellegrini CA, Broderick WC, Way LW. Pigment sludge and stone formation in the acutely ligated dog gallbladder. Gastroenterology, 1983; 85: 1166–71.
3. Besso JG, Wrigley RH, Gliatto JM, Wenster CR. Ultrasonographic appearance and clinical findings in 14 dogs with gallbladder mucocele. Vet Radiol Ultrasoun. 2000; 41 (3): 261–71.
4. Brömel C, Barthez PY, Léveillé R, Scrivani PV. Prevalence of gallbladder sludge in dogs as assessed by ultrasonography. Vet Radiol Ultrasoun 1998; 39 (3): 206–10.
5. Choi J, Kim A, Keh S, Oh J, Kim H, Yoon J. Comparison between ultrasonographic and clinical findings in 43 dogs with gallbladder mucoceles. Vet Radiol Ultrasound 2014; 55(2): 202–7.
6. Cullen JM. Liver, biliary system and exocrine pancreas. In: McGavin Z, eds: Pathologic basis of veterinary disease. 4th ed., Mosby Elsevier, Missouri USA, 2007; pp. 393-461.
7. González FD, Silva SC. Perfil bioquímico sanguíneo. In: Introdução à Bioquímica Clínica Veterinária, 2th ed, Editora Universidade Federal do Rio Grande do Sul, Porto Alegre, 2006; pp. 313-359.
8. Hoffmann WE, Solter PF. Diagnostic enzymology of domestic animals. In: Kaneko JJ, Harvey JW, Bruss ML, eds: Clinical Biochemistry of Domestic Animals, 6th ed. Academic Press, San Diego, 2008; pp. 351-378.

9. Jüngst C, Ublick GAK, Jüngst D. Microlithiasis and sludge. Best Pract Res Clin Gastroenterol. 2006; 20 (6): 1053–62.
10. Ko CW, Sekijima JH, Lee SP. Biliary sludge. Ann Intern Med. 1999; 130 (4): 301–11.
11. Nyland TG, Mattoon JS. Veterinary diagnostic ultrasonography. WB Saunders Company, Philadelphia, USA, 2002.
12. Pazzi P, Gamberini S, Buldrini P, Gullini S. Biliary sludge: the sluggish gallbladder. Dig Liver Dis. 2003; 35(3): 39–45.
13. Radlinsky MG. Surgery of the extrahepatic biliary system. In: Fossum TW, eds: Small animal surgery 4th ed. Elsevier, Canada, 2013; pp. 618-633.
14. Secchi P, Pöppl AG, Ilha A, Filho HCK, Lima FES, Garcia AB, González FHD. Prevalence, risk factors, and biochemical markers in dogs with ultrasound-diagnosed biliary sludge. Res Vet Sci. 2012; 93, 1185–1189.
15. Stark R, Gazsi N, Nagy CF, Jakab C. Cystic mucinous hyperplasia of gallbladder in dogs. Hungar Vet J 2010; 132 (3): 176-85.
16. Uno T, Okamoto K, Onaka T, Fujita K, Yamamura H, Sakai T. Correlation between ultrasonographic imaging of the gallbladder and gallbladder content in eleven cholecystectomised dogs and their prognoses. J Vet Med Sci 2009; 71: 1295–1300.
17. Watson PJ, Bunch SE. Testes diagnósticos para o sistema hepatobiliar. In: Nelson RW, Couto CG, Eds: Medicina Interna de Pequenos Animais, 4th ed. Elsevier, Rio de Janeiro, 2010; pp. 496–512.