Colecistoduodenostomia para tratamento de obstrução biliar secundária a platinossomose felina / Cholecystoduodenostomy for treatment of biliary obstruction secondary to feline platinossomosis

Background: Platynosomum spp. it is a trematode that has a predilection for the liver and biliary tissues whose infection isacquired through the ingestion of metacercarian gecko viscera. Felines are the definitive hosts and clinical signs are variable.The diagnosis is through history, hematological and biochemical exams, ultrasound, bile cytology or histopathology. Thetreatment of choice is cholecystoduodenostomy. This paper aims to report the case of a cat who was treated at the UberabaVeterinary Hospital with chronic cholangitis secondary to platinosomosis, but there was a transfusion reaction and she died.Case: A 4-year-old, uncastrated SRD cat was treated at the Uberaba Veterinary Hospital complaining of severe episodesof vomiting three days ago, hyporexia and darkened urine. The general clinical examination showed moderate dehydration, jaundice and hepatomegaly. The animal was hospitalized for better investigation of its condition. Increased valuesof ALT, alkaline phosphatase and all bilirubins were observed. Ultrasound showed liver suggestive of liver disease andsteatosis, and gallbladder without alteration. During hospitalization, she remained jaundiced and hypoxic, and the esophageal tube was placed. The initial clinical suspicion was cholangiohepatitis. Liver biopsy and cholecystoduodenostomywere then suggested, with refusal by the tutor. The ultrasound was repeated and showed the same alterations described,besides cholangitis. Stool examination was negative for Platynosomum spp. and positive for Isospora spp. The patientwas treated with anthelmintic for three days and received supportive treatment for another week until the tutor authorizedcholecystoduodenostomy. During surgery, cholecystocentesis was performed and the parasite Platynosomum spp. in adultform. After four days, a new blood count was done and the animal was still anemic and the blood...(AU)

Colecistoduodenostomia para tratamento de obstrução biliar secundária a platinossomose felina / Cholecystoduodenostomy for treatment of biliary obstruction secondary to feline platinossomosis

Background: Platynosomum spp. it is a trematode that has a predilection for the liver and biliary tissues whose infection isacquired through the ingestion of metacercarian gecko viscera. Felines are the definitive hosts and clinical signs are variable.The diagnosis is through history, hematological and biochemical exams, ultrasound, bile cytology or histopathology. Thetreatment of choice is cholecystoduodenostomy. This paper aims to report the case of a cat who was treated at the UberabaVeterinary Hospital with chronic cholangitis secondary to platinosomosis, but there was a transfusion reaction and she died.Case: A 4-year-old, uncastrated SRD cat was treated at the Uberaba Veterinary Hospital complaining of severe episodesof vomiting three days ago, hyporexia and darkened urine. The general clinical examination showed moderate dehydration, jaundice and hepatomegaly. The animal was hospitalized for better investigation of its condition. Increased valuesof ALT, alkaline phosphatase and all bilirubins were observed. Ultrasound showed liver suggestive of liver disease andsteatosis, and gallbladder without alteration. During hospitalization, she remained jaundiced and hypoxic, and the esophageal tube was placed. The initial clinical suspicion was cholangiohepatitis. Liver biopsy and cholecystoduodenostomywere then suggested, with refusal by the tutor. The ultrasound was repeated and showed the same alterations described,besides cholangitis. Stool examination was negative for Platynosomum spp. and positive for Isospora spp. The patientwas treated with anthelmintic for three days and received supportive treatment for another week until the tutor authorizedcholecystoduodenostomy. During surgery, cholecystocentesis was performed and the parasite Platynosomum spp. in adultform. After four days, a new blood count was done and the animal was still anemic and the blood...

Colecistectomía asociada a enterotomia duodenal en una infestación por Platynosomum sp. en un gato doméstico / Cholecystectomy associated to duodenal enterotomy in the infestation by Platynosomum sp. in a domestic cat / Colecistectomia associada à enterotomia duodenal na infestação por Platynosomum sp. em um gato doméstico

Platynosomum sp. es el más grande parásito hepatobiliar de la familia Felidae, causador de una lesión obstructiva extrahepática que puede ser tratada por cirugía. Un felino, sin raza definida, dos años de edad, semidomiciliado, fue atendido con un cuadro clínico de apatía, ictericia, deshidratación y elevación de enzimas hepáticas. En la ecografía abdominal se observó el hígado aumentado, vasos hepáticos y la vena porta con un mayor diámetro, la vesícula llena de contenido anecoico, sedimentación, espesamiento y hiperrefringencia de la pared de el conducto biliar principal dilatado con pared gruesa. Fue realizada colecistectomía con enterotomia duodenal. La inspección de los contenidos de la vesícula biliar reveló parásitos con una apariencia aplanada y la evaluación microscópica fue consistente con Platynosomum sp. El tratamiento con niclosamida y oxibendazol fue efectivo. Colecistectomía asociada con enterotomia duodenal es eficaz en tales casos.

Platynosomum sp. is the major hepatobiliary parasite of felids, causing an extra-hepatic obstructive lesion which may be treated by surgery. A two-year old cross-bred feline, semi-domiciled, was attended with a clinical picture of apathy, jaundice, dehydration and increase in hepatic enzymes. In the abdominal ultrasonography the liver was observed enlarged, hepatic and portal veins with increased diameter, gall bladder filled by anechoic content, with sediment, thickening and hyperechogenicity of the wall and a dilated main bile duct with a thickened wall. The cholecystectomy with a duodenal enterotomy was performed. The inspection of the gall bladder’s content revealed parasites with a flattened aspect and the microscopic evaluation was compatible with Platynosomum sp. A treatment with niclosamide and oxibendazole was efficient. Cholecystectomy associated to a duodenal enterotomy is efficient in these cases.

Platynosomum sp. é o maior parasito hepatobiliar de felídeos, causando uma lesão obstrutiva extra-hepática a qual pode ser tratada por cirurgia. Um felino, de dois anos de idade, sem raça definida, semidomiciliado, foi atendido apresentando um quadro clínico de apatia, icterícia, desidratação e aumento de enzimas hepáticas. Na ultrassonografia abdominal o fígado estava aumentado, vasos hepáticos e veia porta com aumento de diâmetro, vesícula biliar preenchida por conteúdo anecoico, com sedimentação, espessamento e hiperecogenicidade da parede e ducto biliar principal dilatado com parede espessada. Realizou-se a colecistectomia com enterotomia duodenal. A inspeção do conteúdo da vesicular biliar revelou parasitos com um aspecto achatado e a avaliação microscópica foi compatível com Platynosomum sp. O tratamento com niclosamida e oxibendazole foi eficiente. Colecistectomia associada à enterotomia duodenal é eficiente nesses casos.

Colecistectomía asociada a enterotomia duodenal en una infestación por Platynosomum sp. en un gato doméstico / Cholecystectomy associated to duodenal enterotomy in the infestation by Platynosomum sp. in a domestic cat / Colecistectomia associada à enterotomia duodenal na infestação por Platynosomum sp. em um gato doméstico

Platynosomum sp. es el más grande parásito hepatobiliar de la familia Felidae, causador de una lesión obstructiva extrahepática que puede ser tratada por cirugía. Un felino, sin raza definida, dos años de edad, semidomiciliado, fue atendido con un cuadro clínico de apatía, ictericia, deshidratación y elevación de enzimas hepáticas. En la ecografía abdominal se observó el hígado aumentado, vasos hepáticos y la vena porta con un mayor diámetro, la vesícula llena de contenido anecoico, sedimentación, espesamiento y hiperrefringencia de la pared de el conducto biliar principal dilatado con pared gruesa. Fue realizada colecistectomía con enterotomia duodenal. La inspección de los contenidos de la vesícula biliar reveló parásitos con una apariencia aplanada y la evaluación microscópica fue consistente con Platynosomum sp. El tratamiento con niclosamida y oxibendazol fue efectivo. Colecistectomía asociada con enterotomia duodenal es eficaz en tales casos.(AU)

Platynosomum sp. is the major hepatobiliary parasite of felids, causing an extra-hepatic obstructive lesion which may be treated by surgery. A two-year old cross-bred feline, semi-domiciled, was attended with a clinical picture of apathy, jaundice, dehydration and increase in hepatic enzymes. In the abdominal ultrasonography the liver was observed enlarged, hepatic and portal veins with increased diameter, gall bladder filled by anechoic content, with sediment, thickening and hyperechogenicity of the wall and a dilated main bile duct with a thickened wall. The cholecystectomy with a duodenal enterotomy was performed. The inspection of the gall bladders content revealed parasites with a flattened aspect and the microscopic evaluation was compatible with Platynosomum sp. A treatment with niclosamide and oxibendazole was efficient. Cholecystectomy associated to a duodenal enterotomy is efficient in these cases.(AU)

Platynosomum sp. é o maior parasito hepatobiliar de felídeos, causando uma lesão obstrutiva extra-hepática a qual pode ser tratada por cirurgia. Um felino, de dois anos de idade, sem raça definida, semidomiciliado, foi atendido apresentando um quadro clínico de apatia, icterícia, desidratação e aumento de enzimas hepáticas. Na ultrassonografia abdominal o fígado estava aumentado, vasos hepáticos e veia porta com aumento de diâmetro, vesícula biliar preenchida por conteúdo anecoico, com sedimentação, espessamento e hiperecogenicidade da parede e ducto biliar principal dilatado com parede espessada. Realizou-se a colecistectomia com enterotomia duodenal. A inspeção do conteúdo da vesicular biliar revelou parasitos com um aspecto achatado e a avaliação microscópica foi compatível com Platynosomum sp. O tratamento com niclosamida e oxibendazole foi eficiente. Colecistectomia associada à enterotomia duodenal é eficiente nesses casos.(AU)

Colecistoduodenostomia devido a obstrução total de ducto biliar comum em felino: relato de caso / Colecistoduodenostomia due total obstruction of common biliary duct in feline: case report

As doenças do trato biliar são as patologias hepato-biliares de maior ocorrência em felinos, comumente associadas a processos inflamatórios intestinais e pancreáticos. A obstrução do ducto biliar comum está associada a alta mortalidade e morbidade e pode ocorrer devido doenças inflamatórias, colelitíases, neoplasias, dentre outras causas menos comum. As manifestações clínicas iniciais são inespecíficas, mas a progressão da doença leva a icterícia, emese, anorexia, perda de peso e fezes acólicas. O diagnóstico se dá através de exames laboratoriais e ultrassonografia. A definição de obstrução total do ducto biliar comum requer intervenção cirúrgica, e a definição da técnica irá depender da possível desobstrução do ducto ou restabelecimento do fluxo biliar através da colecistoduodenostomia, ou colecistojejunostomia, associadas a um grande risco cirúrgico e anestésico. Este relato apresenta um caso de um paciente com obstrução total do ducto biliar comum, diagnosticado através da ultrassonografia, sinais clínicos e exames laboratoriais e sua resolução cirúrgica através da técnica de colecistoduodenostomia, que se mostrou efetiva para a melhora clínica do paciente.

Diseases of the biliary tract are the most frequent hepatic biliary diseases in felines, commonly associated with inflammatory bowel and pancreatic processes. Obstruction of the common bile duct is associated with high mortality and morbidity and can occur due to inflammatory diseases, cholelithiasis, neoplasias, among other less common causes. Initial clinical manifestations are nonspecific, but progression of the disease leads to jaundice, emesis, anorexia, weight loss, and stool. The diagnosis is made through laboratory tests and ultrasonography. The definition of total obstruction of the common bile duct requires surgical intervention, and the definition of the technique will depend on the possible duct clearance or reestablishment of the biliary flow through cholecystoduodenostomy, or cholecystochejunostomy, associated with a great surgical and anesthetic risk. This report presents a case of a patient with total obstruction of the common bile duct, diagnosed through ultrasonography, clinical signs and laboratory tests and their surgical resolution through the cholecystoduodenostomy technique, which proved to be effective for the patient’s clinical improvement.

Colecistoduodenostomia devido a obstrução total de ducto biliar comum em felino: relato de caso / Colecistoduodenostomia due total obstruction of common biliary duct in feline: case report

As doenças do trato biliar são as patologias hepato-biliares de maior ocorrência em felinos, comumente associadas a processos inflamatórios intestinais e pancreáticos. A obstrução do ducto biliar comum está associada a alta mortalidade e morbidade e pode ocorrer devido doenças inflamatórias, colelitíases, neoplasias, dentre outras causas menos comum. As manifestações clínicas iniciais são inespecíficas, mas a progressão da doença leva a icterícia, emese, anorexia, perda de peso e fezes acólicas. O diagnóstico se dá através de exames laboratoriais e ultrassonografia. A definição de obstrução total do ducto biliar comum requer intervenção cirúrgica, e a definição da técnica irá depender da possível desobstrução do ducto ou restabelecimento do fluxo biliar através da colecistoduodenostomia, ou colecistojejunostomia, associadas a um grande risco cirúrgico e anestésico. Este relato apresenta um caso de um paciente com obstrução total do ducto biliar comum, diagnosticado através da ultrassonografia, sinais clínicos e exames laboratoriais e sua resolução cirúrgica através da técnica de colecistoduodenostomia, que se mostrou efetiva para a melhora clínica do paciente.(AU)

Diseases of the biliary tract are the most frequent hepatic biliary diseases in felines, commonly associated with inflammatory bowel and pancreatic processes. Obstruction of the common bile duct is associated with high mortality and morbidity and can occur due to inflammatory diseases, cholelithiasis, neoplasias, among other less common causes. Initial clinical manifestations are nonspecific, but progression of the disease leads to jaundice, emesis, anorexia, weight loss, and stool. The diagnosis is made through laboratory tests and ultrasonography. The definition of total obstruction of the common bile duct requires surgical intervention, and the definition of the technique will depend on the possible duct clearance or reestablishment of the biliary flow through cholecystoduodenostomy, or cholecystochejunostomy, associated with a great surgical and anesthetic risk. This report presents a case of a patient with total obstruction of the common bile duct, diagnosed through ultrasonography, clinical signs and laboratory tests and their surgical resolution through the cholecystoduodenostomy technique, which proved to be effective for the patients clinical improvement.(AU)