Ultrasonographic prevalence and proposed morphologic classification of bilobed gallbladder in cats

Objectives Morphologic anomalies of the feline gallbladder (GB) have been previously reported in the literature. These morphologic variants are frequently encountered on routine abdominal ultrasound examination. The aim of this study was to provide an ultrasonographic classification system of these variants and document the overall incidence in the feline population. Methods A prospective, descriptive study was undertaken; cats that had an abdominal ultrasound examination that included at least one sagittal and transverse plane image of the GB were included. GB shape was evaluated and categorized based on a classification scheme of morphologic variants modified from the human literature. Septated (S), bilobed (B1, B2, B3), duplex (D) and complex (C) categories were described. Results Of 516 cats included in the study, 389 had normal GB morphology, while 127 had anomalous GB morphology. The overall incidence rate of anomalous GB morphology was 24.61%. When examined by morphologic type, the septated (S) morphology had an incidence of 9.69%. A bilobed (B) morphology was the most commonly observed classification; incidence was 14.35% within our population; incidence of B1, B2 and B3 subtypes were 2.91%, 6.98% and 4.46%, respectively. Duplex GBs only made up 0.39% of the total population. The incidence of complex (C) morphologies was 0.19%. Conclusions and relevance The incidence of GB morphologic anomalies was higher in our population than previously reported. Identification of these anomalies on routine ultrasound evaluation is common; numerous different morphologies can be identified and a standardized classification scheme is proposed. Complete evaluation of morphology can be challenging, particularly with regard to cystic duct anatomy. Clinical significance is uncertain and future studies are warranted to determine the relationship between morphologic variants and hepatobiliary disease.

Ultrasound and excretory urography findings in the diagnostic of congenital renal ectopy of a dog

Renal ectopy is a rare condition in small animals, characterized by abnormal positioning of one or both kidneys. It is classified as simple or crossed and, according to its localization, being diagnosed in an incidental way in pets because of its nonspecific and many times asymptomatic clinical presentation. Imaging exams such as ultrasound, radiography, and excretory urography may close the diagnosis. This paper reports a case of simple, unilateral, renal ectopy, in a three-year-old male Lhasa Apso dog, with no clinical or laboratory findings consistent with renal disease, in which the ectopic condition, together with shape, rotation, and vascular abnormalities, were incidental findings during abdominal ultrasound examination.

Surgical Treatment of Oesophagostomum spp. Nodular Infection in a Chimpanzee at the CIRMF Primatology Center, Gabon

Oesophagostomosis is a zoonotic disease caused by nematodes of the genus Oesophagostomum in the intestinal walls of many species, including ruminants, pigs, humans, and nonhuman primates. Although great apes appear to tolerate the parasite in the wild, they can develop a clinical form that can lead to death in captivity and the natural environment. At the Primatology Centre of the International Centre for Medical Research in Franceville (CIRMF) in Gabon, we recorded 4 deaths of chimpanzees (Pan t. troglodytes) caused by Oesophagostomum spp. between 2015 and 2019. In each case, coprological analysis was positive for strongylid eggs and abdominal ultrasound revealed nodules about 4 cm in diameter on the intestinal and abdominal walls. Albendazole treatments administered by mouth in two doses of 400 mg six months apart resulted in the disappearance of the parasite in coprological samples but the chimpanzees still died. Autopsies carried out on all four chimpanzees revealed a rupture of the cysts and a discharge of pus into the abdomen in each case. We report surgical management involving the removal of Oesophagostomum spp. cysts from a chimpanzee following coprological analysis and abdominal ultrasound examination. Surgical exploration confirmed the fragility of the cystic walls, the rupture of which we avoided. This 5th new case of Oesophagostomum ssp. nodules recovered without complications following the operation and could rejoin his group. We suggest that surgical intervention should be considered in similar cases in captive primates, especially chimpanzees.

Development of a non-functional pancreatic neuroendocrine tumor and a duodenal ulceration after cholecystoduodenostomy in a cat

A six-year-old Ragdoll with previous extrahepatic biliary tract obstruction due to cholangiohepatitis, treated with cholecystoduodenostomy, was presented for acute vomiting, hyporexia, and weight loss. Abdominal ultrasound examination revealed randomly distributed hepatic nodules and dilated biliary ducts. Gastroduodenoscopy showed a patent cholecystoduodenostoma but disclosed a perforated duodenal ulceration. Conversion to celiotomy revealed extensive liver pathology, a discrete pancreatic nodule, and a duodenal ulcer opposite to the cholecystoduodenostoma. The cat was euthanized intra-operatively and necropsy was performed. The intrahepatic biliary tract of the right liver lobes was obstructed and severely dilated, whereas bile from the left lobes drained through the cholecystoduodenostoma. Histopathologic diagnoses were a primary pancreatic tumor, positive for glucagon on immunohistochemistry, with liver metastases, chronic purulent cholecystitis, and duodenal ulceration. To the authors’ knowledge, this is the first report in which the development of pancreatic neoplasia is described in a cat with a history of biliary tract disease.

Mayer-Rokitansky-Küster-Hauser syndrome

Abstrak. Mayer–Rokitansky–Küster–Hauser syndrome (MRKH) adalah suatu sindrom yang ditandai dengan aplasia uterus, serviks, dan 2/3 vagina bagian atas karena perkembangan yang tidak sempurna dari duktus Mullerian. Dilaporkan seorang perempuan berusia 26 tahun yang mengeluh belum pernah menstruasi sampai saat ini. Secara fenotip pasien tampak sebagai perempuan yang memiliki perawakan normal. Payudara dan distribusi pertumbuhan rambut aksila serta kemaluan berkembang normal, disertai pertumbuhan lemak pada bokong dan paha. Tuba fallopi, rahim, dan vagina 2/3 proksimal tidak terbentuk. Pada pemeriksaan klinis ginekologi tampak introitus vagina dengan sonde vagina sepanjang 2 cm. Pemeriksaan USG abdominal, uterus berupa garis dan kedua ovarium sulit dinilai. Pemeriksaan MRI didapatkan agenesis uterus dan agenesis adnexa. Pemeriksaan analisa hormonal, LH 9,81 mIU/mL, FSH 6,87 mIU/mL, progesteron 0,51 ng/mL, estradiol 46,4 pg/mL, testosteron 60,45 mg/dl, TSH 1,216 mIU/L, T4 11 ug/dl, serta analisa kromosom 46XX. Pasien direncanakan untuk dilakukan vaginoplasti.Kata kunci : sindrom MRKH, anomali duktus Mulleri, vaginoplastiAbstract. Mayer–Rokitansky–Küster–Hauser syndrome (MRKH) is a syndrome characterized by uterine, cervix, and the two third of upper vagina aplasia which is the cause of incomplete development of the Müllerian duct. Reported a case of woman 26 years old, patient has not menstruated until now. The phenotype of the patient appears to be female, and with normal stature. Breast, axilla dan pubic hair distribution, fatty in buttocks and thigh developed normally. Fallopian tubes, uterine and 2/3 upper part of vagina were not formed. On gynecological clinical examination, found vaginal introitus with a vaginal sonde was 2 cm. On abdominal ultrasound examination, the uterus was seen as a line and both ovaries were difficult to assess. MRI examination obtained theresults as uterine and adnexa agenesis. Hormonal analysis showing LH 9.81 mIU/mL, FSH 6.87 mIU/mL, progesteron 0.51 ng/mL, estradiol 46.4 pg/mL, testosterone 60.45 mg/dl, TSH 1.216 mIU/L, T4 11 ug/dl, and chromosome examination is 46 XX. Patient are planned for vaginoplasty. Key words: MRKH syndrome, mullerian duct anomalies, vaginoplasty

DIAGNOSIS OF CONJUGATED ABDOMINAL LESIONS IN PANCREATIC INJURY

Summary. Resume. Traumatic injuries of the pancreas by the difficulty in diagnosis and choice of method of therapeutic tactics are some of the most difficult among traumatic lesions of the abdominal organs. The goal of the work. Improvement of results of diagnostics of the combined damages of an abdominal cavity at a trauma of a pancreas Materials and methods. The work is based on the analysis of the results of the examination and surgical treatment of 220 patients with combined damage of the abdominal organs with software trauma from 2000 to 2019. Results and discussion. The features of the topographic-anatomical location of the pancreas more explain the absence of pathognomonic symptoms, the severity of the clinical picture in its trauma. Among 220 patients with combined trauma, 148 (67.3 %) patients were used for diagnostic abdominal ultrasound examination, 52 (23.6 %) ultrasound, and 20 (9.1 %) diagnostic laparoscopy. Conclusions. Screening in patients with “futile” laparotomy has found that the diagnostic value of each method studied is far from optimal and does not allow confirming with confidence or canceling the presence of lesions of the abdominal organs requiring immediate surgery.

Remission of diabetes mellitus after ovariohysterectomy in a guinea pig with ovarian cysts

A 3-year-old intact female guinea pig was presented with a history of polydipsia, polyphagia, and hyperactivity combined with non-pruritic hair loss. The physical examination revealed bilateral alopecia mainly including the flanks and the ventral abdomen. Bilateral rounded masses just caudal to the kidneys were detected on abdominal palpation. Abdominal ultrasound examination confirmed bilateral ovarian cysts and an enlarged uterus with cystic lesions. Blood biochemistry revealed highly increased glucose and fructosamine concentrations. The final diagnoses were diabetes mellitus, bilateral ovarian cysts, and pathologic changes of the uterus. The guinea pig underwent ovariohysterectomy. After surgery, diabetes mellitus and all of the existing clinical signs were fully resolved. A causal relationship between hormonally active ovarian cysts and diabetes mellitus that commonly present independently from each other in the guinea pig can be strongly assumed in the present case. In suspicious cases of gestagen-induced diabetes mellitus ovariohysterectomy could be considered a potential treatment option in guinea pigs.

Asymptomatic Lupus Cystitis with Bilateral Hydronephrosis

Lupus cystitis is a rare complication of systemic lupus erythematosus (SLE). It is characterized by an increase in bladder wall thickness and may be associated with hydroureteronephrosis. Reports, mostly from East Asian countries, indicate that lupus cystitis usually presents with gastrointestinal tract symptoms such as diarrhea, nausea, or abdominal pain. Lower urinarytract symptoms such as dysuria, nocturia, polyuria, and suprapubic pain are also common presenting symptoms. We report a 22-year-old female patient who presented at Cipto Mangunkusumo Teaching Hospital in Indonesia, with profuse and prolonged vaginal bleeding without any other accompanying symptoms. She had a history of polyarthralgias, fever, bleeding gums, anemia, and thrombocytopenia 3 months earlier. Abdominal ultrasound examination revealed bilateral hydronephrosis and a thickened bladder wall; the other organs were normal. Laboratory examination confirmed the diagnosis of SLE complicated by lupus nephritis and lupus cystitis. The patient responded well to the treatment with methylprednisolone. The vaginal bleeding stopped within 2 days, and the laboratory parameters improved. She was discharged on oral methylprednisolone and is scheduled for detailed workup after 1 month.

Simultaneous laparoscopic cholecystectomy with abdominoplasty

Background: The use of laparoscope in surgical removal of gall bladder became one of the most popular surgical procedures and abdominoplasty which was used from long time even during 1900, mostly done as a separate surgical procedure in our research we combined both procedures in the patients subjected to the study.Methods: Thirty-two patients presented to our hospital with abdominal wall laxity and symptomatic cholelithiasis. All of them wanted to undergo a cosmetic procedure (abdominoplasty) to reduce the abdominal wall laxity. They were also diagnosed to have cholelithiasis and had intermittent episodes of pain in the right upper quadrant of the abdomen. The ports for laparoscopic cholecystectomy were made in such a way that all the ports sites were under the elevated skin flap that was excised during abdominoplasty, and there was no scar in the upper abdomen.Results: The procedure was completed without leaving any tell-tale signs of laparoscopic cholecystectomy, and this led to a better cosmetic result from the patients’ point of view.Conclusions:On conclusion, we recommend asking for abdominal ultrasound examination for all patients coming for abdominoplasty especially following weight loss after surgery for morbid obesity even if the patient is asymptomatic. We recommend the use of the technique which we used for port placement as it is convenient, easy, and has no side effects on patients in comparison with other techniques.

Paratuberculosis in a domestic dog in South Africa

This case report shows that Mycobacterium avium subsp. paratuberculosis (MAP) infection can cause clinical disease in domestic dogs, and should be considered as a differential diagnosis for gastrointestinal inflammatory conditions. A male dachshund presented with lethargy and pain. Enlarged mesenteric lymph nodes were found on abdominal ultrasound examination. Cytological examination of lymph node aspirates was consistent with granulomatous inflammation, which was culture-confirmed as MAP. Although we were unable to confirm the source of infection, the dog’s history included exposure to sheep in the Western Cape.