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首页> 外文期刊>The Veterinary Journal >Common bile duct obstruction due to a duodenal gastrinoma in a dog
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Common bile duct obstruction due to a duodenal gastrinoma in a dog

机译：狗十二指肠胃泌素瘤引起的胆总管阻塞

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In dogs gastrinomas are rare endocrine neoplasms that have always been reported to arise from the pancreas. We report here what we believe to be the first case of a duodenal gastrinoma in a dog. A nine-year-old, male, Pekinese dog was presented with a three-day history of anorexia, vomiting and mucous diarrhoea. Clinical examination and laboratory findings suggested the presence of a severe hepatobiliary disorder. Abdominal ultrasonography showed a diffuse increase in echogenicity of the liver, with severe gallbladder dilation and marked dilation of the cystic duct, common bile duct and extrahepatic bile ducts. Based on these findings, an extrahepatic biliary tract obstruction (EBTO) of unknown cause was suspected. At laparotomy, the gallbladder and the extrahepatic bile ducts appeared severely dilated. The gallbladder was tense and could not be compressed suggesting an outflow obstruction. The duodenum at the level of the common duct orifice appeared slightly thickened and severely hardened for a length of 1 cm. Biopsies from the duodenum and liver were obtained and a cholecystoduodenostomy was performed. The duodenal biopsy revealed severe fibrosis of the submucosa and a infiltrate of small pockets and cords of round to polygonal cells with granular cytoplasm. Based on this appearance the differential diagnoses included neuroendocrine tumours and poorly differentiated carcinoma. Despite surgery and supportive therapy the dog continued to be anorexic and to vomit 3-6 times daily. After euthanasia and necropsy, histopathology showed the presence of a neuroendocrine neoplasia involving the duodenal wall with focal invasion of the adjacent pancreas and small liver metastases. On immunohistochemistry, the cytoplasm of approximately 90% of neoplastic cells intensely expressed neuron specific enolase and gastrin. These findings were consistent with a diagnosis of gastrinoma.
机译：在犬类中，胃泌素瘤是罕见的内分泌肿瘤，据报道一直是由胰腺产生的。我们在这里报告我们认为是狗中十二指肠胃泌素瘤的第一例。一只9岁的雄性北京犬出现了三天的厌食，呕吐和粘液腹泻病史。临床检查和实验室检查结果表明存在严重的肝胆疾病。腹部超声检查显示肝脏的回声弥漫性增加，伴有严重的胆囊扩张以及胆囊管，胆总管和肝外胆管的明显扩张。基于这些发现，怀疑原因未知的肝外胆道梗阻（EBTO）。在剖腹手术中，胆囊和肝外胆管出现严重扩张。胆囊紧张，无法压迫，表明​​流出阻塞。在总导管口水平的十二指肠略微增厚并严重硬化，长度为1 cm。从十二指肠和肝脏进行活检，并进行了胆囊十二指肠吻合术。十二指肠活检显示粘膜下层严重纤维化，小囊袋和圆形至多角形颗粒细胞质细胞线浸润。基于这种外观，鉴别诊断包括神经内分泌肿瘤和低分化癌。尽管进行了手术和支持疗法，该犬仍然是厌食症，每天呕吐3至6次。安乐死和尸检后，组织病理学表明存在神经内分泌肿瘤，累及十二指肠壁，并有局灶性侵犯邻近胰腺和小肝转移。在免疫组织化学上，大约90％的肿瘤细胞的细胞质强烈表达神经元特异性烯醇化酶和胃泌素。这些发现与胃泌素瘤的诊断是一致的。

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