Biliary peritonitis in a dog after perforation of the gallbladder during laparoscopic cholecystectomy

Background: Iatrogenic gallbladder perforation during laparoscopic cholecystectomy (LC) is a common complication and occurs in at least one third of human patients undergoing LC. This is attributed to the fragility of the gallbladder wall associated with mucocele and cholecystitis, in addition to the need for repetitive gripping and traction of the gallbladder during its manipulation with laparoscopic instruments. As complications from this event are rare in human patients, conversion to laparotomy is not routinely indicated and the adverse consequences of bile spillage are minimized by abundant irrigation of the peritoneal cavity and adequate antimicrobial therapy. On the other hand, there is little information regarding the outcome of laparoscopic management of this complication in laparoscopic cholecystectomies in dogs, particularly since most surgeons indicate conversion in these cases. Thus, we describe a case of biliary peritonitis that developed in a dog after laparoscopic management of iatrogenic perforation of the gallbladder during a laparoscopic cholecystectomy, in a case of gallbladder mucocele. To the best of our knowledge, there are no reports of biliary peritonitis following laparoscopic management of iatrogenic gallbladder perforation during LC in dogs. Case: A 14-year-old Poodle was referred for clinical evaluation with selective appetite, recurrent episodes of hyporexia, and abdominal discomfort. Ultrasound findings characterized chronic liver disease and gallbladder mucocele. The patient was referred for laparoscopic cholecystectomy, during which the gallbladder was iatrogenically perforated, with extravasation of a large volume of bile content. This complication was managed by copious abdominal irrigation via laparoscopic access and antimicrobial therapy. On the second postoperative day, the patient started to present apathy, hyporexia, emesis, and jaundice. The patient remained hospitalized in the intensive care unit for stabilization and monitoring through hematological examinations and serial abdominal ultrasound. Due to progressive worsening of the clinical picture, an exploratory laparotomy was performed ten days after the initial surgical procedure. This examination showed multiple adhesions and the presence of bile residues adhered to numerous points on the peritoneal surface and pancreas. Despite the intensive treatment instituted, death occurred 10 h after the second surgical procedure. Discussion: The high risk of gallbladder perforation during laparoscopic cholecystectomies correlates with the dissection step or repetitive grasping and traction of the gallbladder with laparoscopic instruments. Conversion is not routinely indicated and laparoscopic management is considered effective in humans. However, in this case, the presence of a large volume of extravasated semisolid bile content and its adherence to the mesothelial surface made it impossible to remove it in its entirety despite the abundant irrigation of the abdominal cavity, resulting in a picture of biliary peritonitis in the postoperative period. In view of the reported negative outcome, the authors encourage the adoption of measures that minimize the risk of gallbladder perforation when performing LC in dogs. These include the use of atraumatic instruments or aspiration of bile content before surgical manipulation. Cases in which such a complication is recorded should be carefully monitored to enable early diagnosis and treatment of biliary peritonitis. Furthermore, conversion should be considered when there is extravasation of large volumes of bile, particularly in the presence of gallbladder mucocele, until future studies establish the safety and effectiveness of laparoscopic management of this complication.

Avaliação ultrassonográfica das vias biliares em cães e gatos: coletas e análises de registros médicos veterinários / Ultrasonographic evaluation of the bile ducts in dogs and cats: Collections and analyses of veterinary medical records

Este estudo teve como objetivo avaliar achados ultrassonográficos de cães e gatos diagnosticados com colestase, correlacionando alterações concomitantes com espécies, sexo, idade, peso, sinais clínicos e dilatação das vias biliares. O sistema biliar de pequenos animais é composto pela vesícula biliar e a árvore biliar. Desta forma, os felinos apresentam mais alterações nestas estruturas devido à anatomia diferenciada. A redução do fluxo biliar, conhecida como colestase, ocorre por inúmeras situações, sendo o ultrassom o principal exame diagnóstico empregado na medicina veterinária. Ductos biliares de 4 e 3mm de diâmetro são considerados normais para felinos e caninos, respectivamente. Neste estudo, os sistemas biliares de 41 animais, incluindo felinos e caninos, foram avaliados por ultrassonografia no Setor de Diagnóstico por Imagem do Hospital Veterinário de janeiro de 2019 a fevereiro de 2020, demonstrando a presença de cálculos vesicais em ambas as populações, assim como alterações em ducto cístico associados à pancreatite em cães.

This study aimed to evaluate ultrasound findings of dogs and cats diagnosed with cholestasis, correlating concomitant alterations with species, sex, age, weight, clinical signs, and dilation of bile ducts. The biliary system of small animals is composed of the gallbladder and the biliary tree. Thus, the felines show more alterations in these structures due to their differentiated anatomy. The reduction of the bile flow, known as cholestasis, occurs as a result of numerous situations, with ultrasound being the main diagnostic exam applied in veterinary medicine. Bile ducts of 4 and 3mm diameter are considered normal for felines and canines, respectively. In this study, the biliary systems of 41 animals, including felines and canines, were evaluated using ultrasound at the Diagnostic Imaging Sector of the Veterinary Hospital from January 2019 to February 2020, demonstrating the presence of bladder stones in both populations, as well as changes in the cystic duct associated with pancreatitis in dogs.

Tubular adenoma pyloric-gland type in a cow

The paper describes a typical Pyloric-Gland Type Tubular Adenoma founded in a 7 years old holstein cow. At necropsy, macroscopic examination showed a pedunculated polypoid formation measuring 4.0 cm in its largest diameter in the mucous membrane of the gallbladders body region, with a delicate base in the form of a rod measuring 2.5 cm in length. Histologically analysis showed a tubular cell proliferation covered with cylindrical epithelium, which secreted mucus, with regular, vesicular nuclei with small and regular nucleoli. The stroma was represented by a delicate and loosened, vascularized connective tissue and edema. In the veterinary literature, there is no mention of the occurrence of Pyloric-Gland Type Tubular Adenoma in cattle as well a published description about it.(AU)

Tubular adenoma pyloric-gland type in a cow

The paper describes a typical Pyloric-Gland Type Tubular Adenoma founded in a 7 years old holstein cow. At necropsy, macroscopic examination showed a pedunculated polypoid formation measuring 4.0 cm in its largest diameter in the mucous membrane of the gallbladder’s body region, with a delicate base in the form of a rod measuring 2.5 cm in length. Histologically analysis showed a tubular cell proliferation covered with cylindrical epithelium, which secreted mucus, with regular, vesicular nuclei with small and regular nucleoli. The stroma was represented by a delicate and loosened, vascularized connective tissue and edema. In the veterinary literature, there is no mention of the occurrence of Pyloric-Gland Type Tubular Adenoma in cattle as well a published description about it.

Tumor carcinoide na vesícula biliar em cão / Carcinoid gallbladder tumor in a dog

Carcinoid is a neoplasia that arises from dispersed cells of the neuroendocrine system. This tumor is uncommon in animals, and its occurrence in the gallbladder is rare. A male Basset Hound dog's corpse was taken to the Univerdade Federal de Minas Gerais to be analyzed by the Veterinary Pathology sector, without a description of its previous history. Necropsy revealed the presence of pale oral, ocular and penile mucous membranes. The gallbladder had a thickened wall and a dilated lumen, which was filled with dark and lumpy bile. Its mucosa had a whitish-red nodule, with solid and friable areas. Microscopically, there was a focal neoplastic proliferation, which wasn't encapsulated and had imprecise limits, which cells were distributed in a solid pattern and separated by a delicate fibrovascular stroma. The neoplastic cells presented oval or round shaped nucleus, which had a chromatin predominantly loose, and one or two nucleoli. Their cytoplasm was moderately abundant, and in most of the cells it was eosinophilic, granular, and had well-defined limits. Using the Grimelius coloration, neoplastic cells' cytoplasmic granules stained brownish or black, confirming the neuroendocrine origin of the neoplasia. Based on the macroscopic and microscopic findings, the diagnosis of a gallbladder carcinoid was established.(AU)

A practical new strategy to prevent bile duct injury during laparoscopic cholecystectomy. A single-center experience with 5539 cases

Purpose Bile duct injury (BDI) is a catastrophic complication of cholecystectomy, and misidentification of the cystic anatomy is considered to be the main cause. Although several techniques have been developed to prevent BDI, such as the critical view of safety, the infundibular technique, the rates remain higher during laparoscopic cholecystectomy (LC) than during open surgery. We, here, propose a practical new strategy for ductal identification, that can help to prevent laparoscopic bile duct injury. Methods A retrospective study of 5539 patients who underwent LC from March 2007 to February 2019 at a single institution was conducted. The gallbladder infundibulum was classified by its position located on an imaginary clock with the gallbladder neck as the center point of the dial, 3-oclock position as cranial, 6-oclock as dorsal, 9-oclock as caudal, and 12-oclock as ventral, as well as the axial position. Patient demographics, pathologic variables and infundibulum classification were evaluated. Detailed analysis of ductal identification based on gallbladder infundibulum position was performed in this study. All infundibulum positions were recorded by intraoperative laparoscopic video or photographic images. Results All the patients successfully underwent LC during the study period. No conversion or serious complications such as biliary injury occurred. Gallbladders with infundibulum of 3-oclock position, 6-oclock position, 9-oclock position, 12-oclock position, axial position were 12.3%, 23.4%, 28.0%, 4.2%, and 32.1%, respectively. The 3-oclock and 12-oclock position were pitfalls that might cause biliary injury. Conclusion The gallbladder infundibulum as a navigator is useful for ductal identification to reduce BDI and improve the safety of LC.(AU)

Tumor carcinoide na vesícula biliar em cão / Carcinoid gallbladder tumor in a dog

Carcinoid is a neoplasia that arises from dispersed cells of the neuroendocrine system. This tumor is uncommon in animals, and its occurrence in the gallbladder is rare. A male Basset Hound dog's corpse was taken to the Univerdade Federal de Minas Gerais to be analyzed by the Veterinary Pathology sector, without a description of its previous history. Necropsy revealed the presence of pale oral, ocular and penile mucous membranes. The gallbladder had a thickened wall and a dilated lumen, which was filled with dark and lumpy bile. Its mucosa had a whitish-red nodule, with solid and friable areas. Microscopically, there was a focal neoplastic proliferation, which wasn't encapsulated and had imprecise limits, which cells were distributed in a solid pattern and separated by a delicate fibrovascular stroma. The neoplastic cells presented oval or round shaped nucleus, which had a chromatin predominantly loose, and one or two nucleoli. Their cytoplasm was moderately abundant, and in most of the cells it was eosinophilic, granular, and had well-defined limits. Using the Grimelius coloration, neoplastic cells' cytoplasmic granules stained brownish or black, confirming the neuroendocrine origin of the neoplasia. Based on the macroscopic and microscopic findings, the diagnosis of a gallbladder carcinoid was established.(AU)

A practical new strategy to prevent bile duct injury during laparoscopic cholecystectomy. A single-center experience with 5539 cases

Purpose; Bile duct injury (BDI) is a catastrophic complication of cholecystectomy, and misidentification of the cystic anatomy is considered to be the main cause. Although several techniques have been developed to prevent BDI, such as the “critical view of safety”, the infundibular technique, the rates remain higher during laparoscopic cholecystectomy (LC) than during open surgery. We, here, propose a practical new strategy for ductal identification, that can help to prevent laparoscopic bile duct injury.; Methods; A retrospective study of 5539 patients who underwent LC from March 2007 to February 2019 at a single institution was conducted. The gallbladder infundibulum was classified by its position located on an imaginary clock with the gallbladder neck as the center point of the dial, 3-oclock position as cranial, 6-oclock as dorsal, 9-oclock as caudal, and 12-oclock as ventral, as well as the axial position. Patient demographics, pathologic variables and infundibulum classification were evaluated. Detailed analysis of ductal identification based on gallbladder infundibulum position was performed in this study. All infundibulum positions were recorded by intraoperative laparoscopic video or photographic images.; Results; All the patients successfully underwent LC during the study period. No conversion or serious complications such as biliary injury occurred. Gallbladders with infundibulum of 3-oclock position, 6-oclock position, 9-oclock position, 12-oclock position, axial position were 12.3%, 23.4%, 28.0%, 4.2%, and 32.1%, respectively. The 3-oclock and 12-oclock position were pitfalls that might cause biliary injury.; Conclusion; The gallbladder infundibulum as a navigator is useful for ductal identification to reduce BDI and improve the safety of LC.(AU)

Colangitis crónica asociada a la infestación por trematodo hepático causado por Platynosomum fastosum, concurrente con la duplicación de la vesícula biliar en el gato doméstico: presentación de un caso / Chronic cholangitis associated with liver fluke infestation caused by Platynosomum fastosum, concurrent with gallbladder duplication in a domestic cat: case report / Colangite crônica associada à infestação de trematódeo por Platynosomum fastosum, concomitante à vesícula biliar dupla em um gato: relato de caso

Este trabajo pretende informar un caso de un felino de cinco años mestizo, presentando intensa ictericia, petequias y equimosis cutánea generalizada, aumento de enzima ALT, aumento del colesterol sérico y disminución de las proteínas plasmáticas. Se instituyó el tratamiento médico, pero el animal murió dos días después de la intervención clínica. El examen histopatológico mostró colangitis crónica asociada con infestación por trematodos Platynosomum fastosumy verdadera duplicación de la vesícula biliar. Se conclui que los cambios anatómicos asociados con la infestación por parásitos pueden agravar significativamente el cuadro clínico de colangitis crónica y siempre debe ser considerado en el plan de diagnóstico.(AU)

This paper aims to report a case of a 5-years-old, mixed breed cat showing severe jaundice, skin petechiae and ecchymosis, high values of ALT enzyme and serum cholesterol and low plasmatic proteins. A medical treatment was instituted; however the animal died two days after clinical intervention. Anatomicopathological analisys showed a chronic cholangitis associated with liver fluke infestation caused by Platynosomum fastosum, and duplex gallbladder. We conclude that anatomical changes associated with infestation by parasites may significantly aggravate the clinical condition of chronic cholangitis and should always be considered in the diagnostic plan.(AU)

Este trabalho tem o objetivo de relatar um caso de um felino de cinco anos, sem raça definida, apresentando icterícia intensa, petéquias e equimoses cutâneas generalizadas, aumento da enzima ALT, aumento de colesterol sérico e diminuição de proteínas plasmáticas. Foi instituído tratamento médico, entretanto o animal morreu dois dias após a intervenção clínica. No exame anatomopatológico observou-se colangite crônica associada à infestação de trematódeo Platynosomum fastosum e vesícula biliar dupla verdadeira. Conclui-se que alterações anatômicas associadas à infestação por parasitas podem agravar significativamente o quadro clínico de colangite crônica e devem sempre ser consideradas no plano diagnóstico.(AU)

Colangitis crónica asociada a la infestación por trematodo hepático causado por Platynosomum fastosum, concurrente con la duplicación de la vesícula biliar en el gato doméstico: presentación de un caso / Chronic cholangitis associated with liver fluke infestation caused by Platynosomum fastosum, concurrent with gallbladder duplication in a domestic cat: case report / Colangite crônica associada à infestação de trematódeo por Platynosomum fastosum, concomitante à vesícula biliar dupla em um gato: relato de caso

Este trabajo pretende informar un caso de un felino de cinco años mestizo, presentando intensa ictericia, petequias y equimosis cutánea generalizada, aumento de enzima ALT, aumento del colesterol sérico y disminución de las proteínas plasmáticas. Se instituyó el tratamiento médico, pero el animal murió dos días después de la intervención clínica. El examen histopatológico mostró colangitis crónica asociada con infestación por trematodos Platynosomum fastosumy verdadera duplicación de la vesícula biliar. Se conclui que los cambios anatómicos asociados con la infestación por parásitos pueden agravar significativamente el cuadro clínico de colangitis crónica y siempre debe ser considerado en el plan de diagnóstico.

This paper aims to report a case of a 5-years-old, mixed breed cat showing severe jaundice, skin petechiae and ecchymosis, high values of ALT enzyme and serum cholesterol and low plasmatic proteins. A medical treatment was instituted; however the animal died two days after clinical intervention. Anatomicopathological analisys showed a chronic cholangitis associated with liver fluke infestation caused by Platynosomum fastosum, and duplex gallbladder. We conclude that anatomical changes associated with infestation by parasites may significantly aggravate the clinical condition of chronic cholangitis and should always be considered in the diagnostic plan.

Este trabalho tem o objetivo de relatar um caso de um felino de cinco anos, sem raça definida, apresentando icterícia intensa, petéquias e equimoses cutâneas generalizadas, aumento da enzima ALT, aumento de colesterol sérico e diminuição de proteínas plasmáticas. Foi instituído tratamento médico, entretanto o animal morreu dois dias após a intervenção clínica. No exame anatomopatológico observou-se colangite crônica associada à infestação de trematódeo Platynosomum fastosum e vesícula biliar dupla verdadeira. Conclui-se que alterações anatômicas associadas à infestação por parasitas podem agravar significativamente o quadro clínico de colangite crônica e devem sempre ser consideradas no plano diagnóstico.

Características ultrassonográficas de fígado, vesícula biliar, rins, vesícula urinária e jejuno em coelhos jovens e adultos / Ultrasound features of liver, gallbladder kidneys, urinary bladder and jejunum in young and adult rabbits

O presente trabalho descreveu características e comparou mensurações do fígado, vesícula biliar, rins, vesícula urinária e jejuno de coelhos da raça Nova Zelândia Branco (NZB) jovens e adultos. O grupo dos jovens foi composto por 39 coelhos de ambos os sexos (20 machos e 19 fêmeas), desmamados aos 30-31 dias de idade, sendo as avaliações realizadas aos 35, 56 e 77 dias de idade. O grupo dos adultos foi composto por 23 fêmeas e 15 machos, com idade superior a 6 meses, sendo realizada uma avaliação ultrassonográfica por animal. O exame consistiu na avaliação do fígado, vesícula biliar, rins direito e esquerdo, jejuno e vesícula urinária. Todos os animais foram pesados antes dos exames. O peso médio dos animais aumentou (p<0,05) dos 35 dias até a idade adulta. Tanto nos adultos quanto nos jovens, o fígado apresentou-se predominantemente isoecogênico ao rim direito e com textura homogênea. A vesícula biliar apresentou-se em formato ovoide alongado, variando de piriforme à amendoado, com conteúdo anecogênico, não sendo visível em 2,6% dos coelhos jovens e em 26,3% dos adultos. O comprimento e a largura da vesícula biliar nas idades de 35, 56, 77 dias e adultos foram: 1,06 e 0,39; 1,44 e 0,53; 1,41 e 0,58; 1,57 e 0,67cm, respectivamente. Considerando jovens e adultos, as mensurações da vesícula biliar e dos rins esquerdo e direito apresentaram correlação positiva (p<0,05) com o peso. Os rins apresentaram-se no formato de elipse e com superfície regular, com aumento (p<0,05) dos 35 dias à idade adulta. Houve correlação positiva (p<0,05) entre os volumes renais direito e esquerdo. A descrição da vesícula urinária mais encontrada (86%) foi a com conteúdo anecogênico, com pequenas estruturas ecogênicas livres no lúmen, tanto em jovens quanto em adultos. Não houve diferença (p>0,05) da espessura das camadas do jejuno entre as idades, apresentando média de 0,23 cm para todos os animais. Estes são os primeiros dados brasileiros de características ultrassonográficas de fígado, vesícula biliar, rins, jejuno e vesícula urinária para coelhos NZB de 35, 56 e 77 dias de vida e adultos.(AU)

This study described characteristics and measurements of the liver, gallbladder, kidney, urinary bladder and jejunum of young and adults New Zealand White (NZW) rabbits. The young rabbits's group was composed of 39 rabbits of both sexes (20 males and 19 females), weaned at 30-31 days of age, and the evaluations carried out at 35, 56 and 77 days of age. The adults group was composed of 23 females and 15 males, with more than 6 months of age, and one ultrasonographic evaluation per animal. The exam consisted in the evaluation of liver, gallbladder, right and left kidneys, jejunum and urinary bladder. All the animals were weighed before the evaluations. The average weight increased (p<0.05) from 35 days to adults. Both in adult and in young rabbits, the liver presented predominantly isoechogenic in relation of right kidney and with homogeneous texture. The gallbladder had an elongated ovoid shape, ranging for pear-shaped to almond, with anechogenic content, not being visible in 2.6% of young rabbits and 26.3% of adults. The length and width were 1.06 and 0.39; 1.44 and 0.53; 1.41 and 0.58; 1.57 and 0.67cm, respectively at 35, 56, 77 days and adults. For young and adults rabbits, the gallbladder and the left and right kidneys were positively correlated (p<0.05) with weight. The kidneys had an ellipse shape with smooth surface, increasing (p>0.05) from 35 days to adulthood. There was a positive correlation (p<0.05) between the right and left kidney volumes. The description of urinary bladder more frequently (86%) observed was anechogenic content, with small free echogenic structure within the lumen, both in young and in adult rabbits. There was no difference (p>0.05) in the thickness of the layers of the jejunum among ages, with the mean of 0.23cm for all animals. With the results, the first Brazilian ultrasonographic data for liver, gallbladder, kidney, jejunum and urinary bladder were defined to NZW rabbits in 35, 56 and 77days of life, as well as adults.(AU)

Características ultrassonográficas de fígado, vesícula biliar, rins, vesícula urinária e jejuno em coelhos jovens e adultos / Ultrasound features of liver, gallbladder kidneys, urinary bladder and jejunum in young and adult rabbits

O presente trabalho descreveu características e comparou mensurações do fígado, vesícula biliar, rins, vesícula urinária e jejuno de coelhos da raça Nova Zelândia Branco (NZB) jovens e adultos. O grupo dos jovens foi composto por 39 coelhos de ambos os sexos (20 machos e 19 fêmeas), desmamados aos 30-31 dias de idade, sendo as avaliações realizadas aos 35, 56 e 77 dias de idade. O grupo dos adultos foi composto por 23 fêmeas e 15 machos, com idade superior a 6 meses, sendo realizada uma avaliação ultrassonográfica por animal. O exame consistiu na avaliação do fígado, vesícula biliar, rins direito e esquerdo, jejuno e vesícula urinária. Todos os animais foram pesados antes dos exames. O peso médio dos animais aumentou (p<0,05) dos 35 dias até a idade adulta. Tanto nos adultos quanto nos jovens, o fígado apresentou-se predominantemente isoecogênico ao rim direito e com textura homogênea. A vesícula biliar apresentou-se em formato ovoide alongado, variando de piriforme à amendoado, com conteúdo anecogênico, não sendo visível em 2,6% dos coelhos jovens e em 26,3% dos adultos. O comprimento e a largura da vesícula biliar nas idades de 35, 56, 77 dias e adultos foram: 1,06 e 0,39; 1,44 e 0,53; 1,41 e 0,58; 1,57 e 0,67cm, respectivamente. Considerando jovens e adultos, as mensurações da vesícula biliar e dos rins esquerdo e direito apresentaram correlação positiva (p<0,05) com o peso. Os rins apresentaram-se no formato de elipse e com superfície regular, com aumento (p<0,05) dos 35 dias à idade adulta. Houve correlação positiva (p<0,05) entre os volumes renais direito e esquerdo. A descrição da vesícula urinária mais encontrada (86%) foi a com conteúdo anecogênico, com pequenas estruturas ecogênicas livres no lúmen, tanto em jovens quanto em adultos. Não houve diferença (p>0,05) da espessura das camadas do jejuno entre as idades, apresentando média de 0,23 cm para todos os animais. Estes são os primeiros dados brasileiros de características ultrassonográficas de fígado, vesícula biliar, rins, jejuno e vesícula urinária para coelhos NZB de 35, 56 e 77 dias de vida e adultos.(AU)

This study described characteristics and measurements of the liver, gallbladder, kidney, urinary bladder and jejunum of young and adults New Zealand White (NZW) rabbits. The young rabbits's group was composed of 39 rabbits of both sexes (20 males and 19 females), weaned at 30-31 days of age, and the evaluations carried out at 35, 56 and 77 days of age. The adults group was composed of 23 females and 15 males, with more than 6 months of age, and one ultrasonographic evaluation per animal. The exam consisted in the evaluation of liver, gallbladder, right and left kidneys, jejunum and urinary bladder. All the animals were weighed before the evaluations. The average weight increased (p<0.05) from 35 days to adults. Both in adult and in young rabbits, the liver presented predominantly isoechogenic in relation of right kidney and with homogeneous texture. The gallbladder had an elongated ovoid shape, ranging for pear-shaped to almond, with anechogenic content, not being visible in 2.6% of young rabbits and 26.3% of adults. The length and width were 1.06 and 0.39; 1.44 and 0.53; 1.41 and 0.58; 1.57 and 0.67cm, respectively at 35, 56, 77 days and adults. For young and adults rabbits, the gallbladder and the left and right kidneys were positively correlated (p<0.05) with weight. The kidneys had an ellipse shape with smooth surface, increasing (p>0.05) from 35 days to adulthood. There was a positive correlation (p<0.05) between the right and left kidney volumes. The description of urinary bladder more frequently (86%) observed was anechogenic content, with small free echogenic structure within the lumen, both in young and in adult rabbits. There was no difference (p>0.05) in the thickness of the layers of the jejunum among ages, with the mean of 0.23cm for all animals. With the results, the first Brazilian ultrasonographic data for liver, gallbladder, kidney, jejunum and urinary bladder were defined to NZW rabbits in 35, 56 and 77days of life, as well as adults.(AU)

Características ultrassonográficas de fígado, vesícula biliar, rins, vesícula urinária e jejuno em coelhos jovens e adultos

ABSTRACT: This study described characteristics and measurements of the liver, gallbladder, kidney, urinary bladder and jejunum of young and adults New Zealand White (NZW) rabbits. The young rabbitss group was composed of 39 rabbits of both sexes (20 males and 19 females), weaned at 30-31 days of age, and the evaluations carried out at 35, 56 and 77 days of age. The adults group was composed of 23 females and 15 males, with more than 6 months of age, and one ultrasonographic evaluation per animal. The exam consisted in the evaluation of liver, gallbladder, right and left kidneys, jejunum and urinary bladder. All the animals were weighed before the evaluations. The average weight increased (p 0.05) from 35 days to adults. Both in adult and in young rabbits, the liver presented predominantly isoechogenic in relation of right kidney and with homogeneous texture. The gallbladder had an elongated ovoid shape, ranging for pear-shaped to almond, with anechogenic content, not being visible in 2.6% of young rabbits and 26.3% of adults. The length and width were 1.06 and 0.39; 1.44 and 0.53; 1.41 and 0.58; 1.57 and 0.67cm, respectively at 35, 56, 77 days and adults. For young and adults rabbits, the gallbladder and the left and right kidneys were positively correlated (p 0.05) with weight. The kidneys had an ellipse shape with smooth surface, increasing (p>0.05) from 35 days to adulthood. There was a positive correlation (p 0.05) between the right and left kidney volumes. The description of urinary bladder more frequently (86%) observed was anechogenic content, with small free echogenic structure within the lumen, both in young and in adult rabbits. There was no difference (p>0.05) in the thickness of the layers of the jejunum among ages, with the mean of 0.23cm for all animals. With the results, the first Brazilian ultrasonographic data for liver, gallbladder, kidney, jejunum and urinary bladder were defined to NZW rabbits in 35, 56 and 77days of life, as well as adults.

RESUMO: O presente trabalho descreveu características e comparou mensurações do fígado, vesícula biliar, rins, vesícula urinária e jejuno de coelhos da raça Nova Zelândia Branco (NZB) jovens e adultos. O grupo dos jovens foi composto por 39 coelhos de ambos os sexos (20 machos e 19 fêmeas), desmamados aos 30-31 dias de idade, sendo as avaliações realizadas aos 35, 56 e 77 dias de idade. O grupo dos adultos foi composto por 23 fêmeas e 15 machos, com idade superior a 6 meses, sendo realizada uma avaliação ultrassonográfica por animal. O exame consistiu na avaliação do fígado, vesícula biliar, rins direito e esquerdo, jejuno e vesícula urinária. Todos os animais foram pesados antes dos exames. O peso médio dos animais aumentou (p 0,05) dos 35 dias até a idade adulta. Tanto nos adultos quanto nos jovens, o fígado apresentou-se predominantemente isoecogênico ao rim direito e com textura homogênea. A vesícula biliar apresentou-se em formato ovoide alongado, variando de piriforme à amendoado, com conteúdo anecogênico, não sendo visível em 2,6% dos coelhos jovens e em 26,3% dos adultos. O comprimento e a largura da vesícula biliar nas idades de 35, 56, 77 dias e adultos foram: 1,06 e 0,39; 1,44 e 0,53; 1,41 e 0,58; 1,57 e 0,67cm, respectivamente. Considerando jovens e adultos, as mensurações da vesícula biliar e dos rins esquerdo e direito apresentaram correlação positiva (p 0,05) com o peso. Os rins apresentaram-se no formato de elipse e com superfície regular, com aumento (p 0,05) dos 35 dias à idade adulta. Houve correlação positiva (p 0,05) entre os volumes renais direito e esquerdo. A descrição da vesícula urinária mais encontrada (86%) foi a com conteúdo anecogênico, com pequenas estruturas ecogênicas livres no lúmen, tanto em jovens quanto em adultos. Não houve diferença (p>0,05) da espessura das camadas do jejuno entre as idades, apresentando média de 0,23 cm para todos os animais. Estes são os primeiros dados brasileiros de características ultrassonográficas de fígado, vesícula biliar, rins, jejuno e vesícula urinária para coelhos NZB de 35, 56 e 77 dias de vida e adultos.

COLECISTECTOMIA LAPAROSCÓPICA UTILIZANDO DISPOSITIVO SELANTE DE VASOS E MODIFICAÇÃO DA TÉCNICA UTILIZANDO NÓ EXTRACORPÓREO EM COELHOS: ESTUDO EXPERIMENTAL

As cirurgias laparoscópicas possuem vantagens conhecidas sendo amplamente utilizada na medicina humana, havendo tendência muito grande de redução dos procedimentos cirúrgicos abertos. Contudo, na medicina veterinária, esse avanço nas videocirurgias não ocorre da mesma maneira. As cirurgias minimamente invasivas ainda estão restritas a alguns centros, havendo poucas pesquisas que buscam o avanço das técnicas em pequenos animais. A colecistectomia laparoscópica (CL) é técnica cirúrgica minimamente invasiva recente na medicina veterinária. Estudos randomizados in vivo que avaliam diferentes métodos de divulsão e ligadura do trato biliar extra-hepático por laparoscopia comprovam benefícios aos pacientes. Sendo assim, o objetivo deste estudo randomizado foi relatar as complicações e os resultados perioperatórios de coelhos submetidos a três técnicas diferentes de CL. 30 coelhos foram divididos em 3 grupos. Grupo A (n = 10): técnica de CL iniciando-se pelo fundo da vesícula biliar (VB) em direção ao ducto cístico (Retrógada) pelo instrumento de dissecção Hook e aplicação de nó extracorpóreo para ligadura de ducto cístico. Grupo B (n = 10): técnica de CL convencional por pinça Maryland bipolar para dissecção da VB e Dispositivo Selante de Vasos (DSV- LigaSure ) para selagem do ducto cístico. Grupo C (n = 10): técnica de CL convencional com utilização de DSV para dissecção da VB e DSV para selagem de ducto cístico. Os dados dos procedimentos cirúrgicos foram coletados e analisados (taxa de perfuração da VB, sangramento dos tecidos adjacentes à iv VB, tempo para dissecção da VB e tempo total de cirurgia). A função hepática: AST, ALT, FA, BT, BD, GGT e fibrinogênio foi avaliada no pré-operatório e nos dias 3,7 15 após a cirurgia. Avaliações ultrassonográficas seriadas foram realizadas no período pós-operatório a fim de se verificar ausência de extravasamento de bile e peritonite biliar. Alterações abdominais macroscópicas foram verificadas aos quinze dias de pós-operatório por meio da necropsia e o grau de aderências pós-operatórias foi classificado de 0 a 4. Amostras de fígado para avaliação histopatológica foram coletadas de todos os animais. Foi avaliada a presença de siderófagos e utilizada uma escala de 1 a 4 para o grau de fibrose, necrose e células gigantes. O grupo A apresentou um tempo de dissecção da VB maior do que os grupos B e C. A perfuração do VB e sangramento dos tecidos adjacentes ao VB foram semelhantes entre os grupos testados. Os níveis de GGT e ALP aumentaram (p0,05) no dia 3 pós-operatório no grupo A. No 15º dia pós-operatório, as enzimas voltaram aos valores pré-operatórios. A mediana de células gigantes, necrose, fibrose e proporção de siderofagos não foram influenciadas pelas técnicas de CL. Conclui-se que elevações transitórias em enzimas hepatocelulares de coelhos após CL podem ser uma observação benigna e podem não ter quaisquer características clínicas. O grupo A teve um escore de adesão maior do que os grupos B e C e foi associado à técnica menos previsível. A CL pode ser realizada por meio de diferentes técnicas, embora o uso de DSV seja altamente recomendado.

Laparoscopic cholecystectomy (LC) has become the gold standard management option for benign gallbladder (GB) disease and cholelithiasis. The aim of this randomized study was to evaluate the intraoperative complications and perioperative outcome of rabbits undergoing 3 different techniques of LC. In this study, we compared the effect of different LC techniques on changes in liver function tests (LFTs). And finally, we investigated and compared the degree of postoperative adhesions and histopathological changes of the liver bed after LC techniques. Methods:30 white male New Zealand rabbits were divided into 3 groups. Group A (n=10) Fundus-first dome-down technique by Hook dissecting instrument and Roeder Slipknot applied for Cystic Duct Ligation. The GB was dissected free from the liver bed starting at the fundus toward the GB neck using Hook electrocautery (KarlStorz 36 cm length). The cystic duct and cystic artery were ligated using extracorporeally Roeder slipknot - extracorporeal slipknot (Roeder knot). Group B (n=10) Conventional technique by Maryland dissecting forceps for GB dissection and Electrothermal Bipolar Vessel Sealing (EVBS) for Cystic duct seal. Rabbits underwent conventional technique using Bipolar Maryland dissecting forceps (maryland36 cm length) and the EVBS LigaSure Maryland Jaw 5mm-23cm (Medtronic, Dublin, Ireland) for Cystic duct seal. Group C conventional technique by Electrothermal Bipolar Vessel Sealing (EBVS) for GB dissection and EVBS for cystic duct seal. Rabbits who underwent conventional technique dissection of the gallbladder by the LigaSure Maryland Jaw 5mm-23cm (Medtronic, Dublin, Ireland) and LigaSure for cystic duct seal. The surgical procedure data were collected and analyzed (GB perforation rate, time to GB bed dissection and length of surgery, bleeding from tissues adjacent to gallbladder)Blood samples were obtained pre-operatively and on day 3, 7 and day 15 after surgery to compare liver enzyme alterations (aspartate transaminase [AST], alanine transaminase [ALT], alkaline phosphatase [ALP], bilirubin, direct bilirubin, total protein, albumin; gamma-glutamyl transferase (GGT), fibrinogen.The necropsy analysis was performed 15 days after surgery, and the degree of postoperative adhesions was classified from 0 to 4. Liver samples for histological examination were taken from all groups. The presence of vi siderophages was evaluated and a scale from 1 to 4 was used for the degree of fibrosis, necrosis and giant cells. Group A presented a longer GB dissection time than groups B and C. GB perforation and bleeding from tissues adjacent to GB were similar among tested groups. GGT and ALP levels increased (p0.05) on day 3 post-operatively in group A. By the 15th postoperative day, the enzymes returned to the preoperative values. The median of giant cells, Necrosis, Fibrosis and proportion of Siderophags were not influenced by the CL techniques. Transient elevation of hepatic transaminases occurred after LC in all groups. Group A had a higher adherence score than groups B and C and was associated with the least predictable technique. LC can be performed using different techniques, although the use of EBVS is highly recommended.

ANÁLISES COMPARATIVAS ENTRE EXAMES ULTRASSONOGRÁFICO E HISTOPATOLÓGICO DA VESÍCULA BILIAR EM CÃES

Na medicina veterinária, doenças restritas à vesícula biliar (VB) são incomuns em cães. Dentre as doenças que acometem os cães e apresentam maior prevalência estão a colecistite, a mucocele da VB, a colelitíase e as neoplasias. O exame histopatológico da VB é apontado como padrão ouro. Entretanto o exame ultrassonográfico abdominal está cada vez mais inserido na rotina da clínica veterinária e se constitui como um exame seguro, pouco invasivo, inócuo e de baixo custo. Ele permite que casos de afecções da VB antes subdiagnosticados passem a ter um diagnóstico mais preciso. Nesse contexto, o objetivo deste estudo foi identificar, quantificar e correlacionar as diferentes lesões da VB de cães diagnosticadas por exames ultrassonográficos e histopatológicos. Foram avaliadas as VB de 60 cadáveres de cães admitidos na rotina do Setor de Patologia Veterinária da Escola de Veterinária da Universidade Federal de Minas Gerais (EV-UFMG), sem predileção por sexo, idade e raça. Os resultados demonstraram que o exame ultrassonográfico, quando correlacionado com o exame histopatológico, apresentou 83% de concordância na análise dos dados gerais para a presença ou ausência de alterações da VB. O nível de concordância no teste de Kappa foi 0,63, o que é considerado um valor substancial. Em comparação, a concordância de Kappa nas afecções estudadas de forma individual obteve-se uma correlação baixa. Correlacionando os dados das análises não paramétricas e os do exame histopatológico, 35% das amostras apresentaram mucocele da VB, 33,3% não apresentaram nenhum tipo de alteração e 30% foram diagnosticadas com hiperplasia mucinosa cística (HMC). As semelhanças entre os achados ultrassonográficos das diferentes afecções da VB como a HMC, mucocele e colecistite indicam que o exame ultrassonográfico não apresenta boa acurácia diagnóstica. Contudo, mais estudos devem ser realizados a fim de se aprofundar o entendimento da correlação entre ultrassonografia e histopatologia para o direcionamento de conclusões diagnósticas.

In veterinary medicine, diseases restricted to the gallbladder (GB) are uncommon in dogs. Among the diseases that affect dogs and are more prevalent are cholecystitis, GB mucocele, cholelithiasis and neoplasms. Histopathological examination of GB is indicated as the gold standard. However, abdominal ultrasound examination is increasingly being performed in veterinary clinics and constitutes a safe, low-invasive, harmless and low-cost examination. It allows cases of GB disorders that were previously underdiagnosed to have a more accurate diagnosis. In this context, the objective of this study was to identify, quantify and correlate the different GB lesions of dogs diagnosed by ultrasound and histopathological exams. The GB of 60 cadavers of dogs admitted to the Veterinary Pathology Sector of the Veterinary School of the Federal University of Minas Gerais (EV-UFMG) were evaluated, with no predilection for sex, age and race. The results demonstrated that the ultrasound examination, when correlated with the histopathological examination, showed 83% agreement in the analysis of the general data for the presence or absence of GB changes. The level of agreement in the Kappa test was 0.63, which is considered a substantial value. In comparison, Kappa's agreement in the conditions studied individually obtained a low correlation. Correlating the data from the non-parametric analyzes and those from the histopathological exam, 35% of the samples presented with a GB mucocele, 33.3% did not present any type of alteration and 30% were diagnosed with cystic mucinous hyperplasia (CMH). The similarities between the ultrasound findings of different GB disorders such as CMH, mucocele and cholecystitis - indicate that the ultrasound examination does not present a good diagnostic accuracy. However, further studies should be carried out in order to deepen the understanding of the correlation between ultrasound and histopathology to guide diagnostic conclusions.

Bacterial microbiota present in the gallbladder of cattle and antimicrobial resistance of Staphylococcus isolates / Microbiota bacteriana presente na vesícula biliar de bovinos e resistência antimicrobiana de isolados de Staphyloccocus

Pathogenic microorganisms can reside transiently or permanently in the gallbladder of cattle. Thus, during slaughter, more attention should be given to the gastrointestinal tract, especially to the accessory organ, the gallbladder. The main aim of this study was to characterize the bacterial microbiota present in bile and gallbladder epithelium of cattle slaughtered in a slaughtering plant under sanitary conditions and to evaluate the antimicrobial resistance in strains of the genus Staphylococcus. Thirty intact gallbladders were collected and the in bile and epithelium were researched for the presence of Aerobic Mesophilic Heterotrophic Bacteria (AMHB), Staphylococcus spp., total Enterobacteriaceae, Enterococcus spp. and Salmonella spp.The frequency of isolation of the microorganism mentioned above were, respectively: 23.02 percent, 14.39 percent, 13.67 percent, 24.46 percent, 0 percent and 24.46 percent. Concerning both gallbladder environments, the frequency of isolation of the microorganisms in the epithelium was 64.03 percent, and in the bile 35.97 percent, with no statistical difference, but with significant difference between the population averages. In antimicrobial susceptibility testing, strains of Staphylococcus from both bile and gallbladder epithelium showed sensitivity to the antimicrobials: penicillin G, ceftriaxone, chloramphenicol and gentamicin. The observation that the gallbladder supports a high frequency of microorganisms brings us to the possible fact that cattle might be a persistent carrier of pathogens of great importance to public health.(AU)

Microrganismos patogênicos podem residir temporariamente ou permanentemente na vesícula biliar de bovinos. Assim, durante o abate, maior atenção deve ser dada ao trato gastrointestinal, especialmente para o órgão acessório, a vesícula biliar. O principal objetivo deste estudo foi caracterizar a microbiota bacteriana presente na bile e no epitélio de vesículas biliares de bovinos abatidos em matadouro frigorífico sob inspeção sanitária e avaliar a resistência antimicrobiana de estirpes do gênero Staphyloccocus. Foram coletadas 30 vesículas biliares íntegras e foi pesquisada na bile e no epitélio do órgão a presença de bactérias heterotróficas aeróbias mesófilas (BHAM), Staphylococcus spp. e Enterobacteriaceae totais, Escherichia coli, Enterococcus spp. e Salmonella spp. A frequência de isolamento dos microrganismos citados acima foi, respectivamente: 23,02 por cento, 14,39 por cento, 13,67 por cento, 24,46 por cento, 0por cento e 24,46 por cento. Em relação aos dois ambientes da vesícula, a frequência de isolamento dos microrganismos no epitélio foi de 64,03 por cento, e na bile 35,97 por cento, não sendo diferente estatisticamente, mas com diferença significativa entre as médias populacionais.No teste de susceptibilidade aos antimicrobianos, as estirpes de Staphylococcus isoladas a partir da bile e do epitélio da vesícula biliar apresentaram sensibilidade a: penicilina G, ceftriaxona, cloranfenicol e gentamicina. A observação de que a vesícula biliar comporta microrganismos em elevadas frequências atenta para o fato de que o bovino possa ser um portador persistente de patógenos de grande importância em saúde pública.(AU)

Transumbilical endoscopic cholecystectomy in a porcine model

PURPOSE: Natural orifice transluminal endoscopic surgery (NOTES) is a new technique. This study describes our initial experience of NOTES and investigates the feasibility of transumbilical endoscopic cholecystectomy (TUEC). METHODS: Eight domestic pigs were submitted to TUEC. After establishment of pneumoperitoneum, a bi-channel endoscope was placed through an infra-umbilical trocar. The gallbladder fundus was lifted by a grasper. The cystic duct and artery was dissected with a flexible hook and clipped by a clip fixing device. The specimen was extracted through the infra-umbilical trocar. RESULTS: The mean operation time was 114 minutes, ranging from 75 to 155 minutes. All the gallbladders were removed successfully. There was one case of subtotal resection, two cases of bleeding and three cases of bile leakage. CONCLUSION: Transumbilical endoscopic cholecystectomy is feasible although it needs more support of experiments and techniques before being applied on human subjects.(AU)

Characterization of bacterial microbiota present in bile and gallbladder epithelium of cattle / Caracterização da microbiota bacteriana presente na bile e epitélio da vesícula biliar de bovinos

Pathogenic microorganisms can reside transiently or permanently in the gallbladder of cattle. Thus, during slaughter, more attention should be given to the gastrointestinal tract, especially to the accessory organ, the gallbladder. The aim of this study was to characterize the bacterial microbiota present in bile and gallbladder epithelium of cattle slaughtered in a slaughtering plant under sanitary conditions. Thirty intact gallbladders were collected and the presence of Total Aerobic Mesophilic Bacteria (TAMB), Staphylococcus spp., Enterobacteriaceae, Escherichia coli, Enterococcus spp. and Salmonella spp. in bile and epithelium were evaluated. The frequency of isolation of the microorganism mentioned above were, respectively: 23.02%, 14.39%, 13.67%, 24.46%, 0% and 24.46%. The frequency of microorganisms isolation the gallbladder epithelium was 64.03% and in the bile was 35.97% but no statistical difference were found. Nevertheless, a significant difference between the population averages can be observed. Staphylococcus strains from bile and gallbladder epithelium showed sensitivity to penicillin G, ceftriaxone, chloramphenicol and gentamicin. The high frequency of microorganisms in the gallbladder brings us to the possible fact that cattle be a persistent carrier of pathogens of great importance to public health.(AU)

Microrganismos patogênicos podem residir temporariamente ou permanentemente na vesícula biliar de bovinos. Assim, durante o abate, maior atenção deve ser dada ao trato gastrointestinal, especialmente para o órgão acessório, a vesícula biliar. O objetivo do estudo foi caracterizar a microbiota bacteriana presente na bile e epitélio de vesículas biliares de bovinos abatidos em matadouro frigorífico sob inspeção sanitária. Foram coletadas 30 vesículas biliares íntegras e pesquisadas na bile e epitélio do órgão a presença de Bactérias Aeróbias Mesófilas Totais (BAMT), Staphylococcus spp. e Enterobacteriaceae, Escherichia coli, Enterococcus spp. e Salmonella spp. A frequência de isolamento dos microrganismos supracitados foi de 23,02%, 14,39%, 13,67%, 24,46%, 0% e 24,46%, respectivamente. Em relação aos dois ambientes da vesícula, a frequência de isolamento dos microrganismos no epitélio foi de 64,03%, e na bile, 35,97%, não sendo diferente estatisticamente, mas com diferença significativa entre as médias populacionais. No teste de susceptibilidade aos antimicrobianos, as estirpes de Staphylococcus isoladas a partir da bile e epitélio da vesícula biliar apresentou sensibilidade a: penicilina G, ceftriaxona, cloranfenicol e gentamicina. A observação de que a vesícula biliar comporta microrganismos em elevadas frequências atenta-nos para o fato de que o bovino possa ser um portador persistente de patógenos de grande importância em saúde pública.(AU)

ASPECTOS ULTRASSONOGRÁFICOS DO FÍGADO E VIAS BILIARES DE FELINOS DOMÉSTICOS PARASITADOS POR Platynosomum sp.

O Platynosomum sp. é o mais importante trematódeo encontrado em gatos de áreas tropicais e subtropicais. Já tendo sido relatado em diferentes localidades do Brasil, onde a maior prevalência registrada foi de 56% no estado do Rio de Janeiro (AZEVEDO, 2008). Objetivou-se descrever os achados ultrassonográficos hepatobiliares de gatos infectados pelo helminto. Foram realizados exames coproparasitológicos para detecção do ovo de Platynosomun sp., que foi encontrado em treze de quatorze gatos testados. Dos animais parasitados, um era Persa e doze sem raça definida (SRD), quatro fêmeas e nove machos, e a idade variou de cinco meses a oito anos. Foram dosadas as enzimas hepáticas alanina aminotransferase (ALT), fosfatase alcalina (FA) e gama glutamil transferase (GGT) e realizado exame ultrassonográfico do sistema hepatobiliar dos gatos. Dois animais apresentaram aumento de ALT e nenhum teve alterações em FA e GGT. Os achados ultrassonográficos foram hepatomegalia (2/13), fígado hipoecoico (3/13), ecotextura heterogênea (3/13), sedimento na vesícula biliar (5/13), cálculo biliar (1/13), espessamento da parede da vesícula biliar (1/13), dilatação do ducto cístico (7/13) e dos ductos extra-hepáticos (7/13), sendo que em um gato os ductos tinham paredes espessadas e hiperecoicas. O volume médio da vesícula biliar foi de 2,37ml. O ducto biliar comum (DBC) foi mensurado em doze gatos, apresentando média de 3,1mm de diâmetro, com intervalo de 1,8 a 4,8mm. O exame ultrassonográfico detectou alterações hepatobiliares na maioria dos gatos com platinossomose. Apenas um animal não apresentou tais achados, porém teve elevação da enzima hepática ALT. É importante estudar a platinossomose, pois é uma das afecções que pode acometer fígado e vesícula biliar de felinos, podendo ser a causa de colangiocarcinomas. Diante disso o exame ultrassonográfico é de fundamental relevância para o diagnóstico precoce da platinossomose.

Platynosomum sp. is the most important trematode found in cats in tropical and subtropical areas. It has been reported in different locations in Brazil, where the highest prevalence was 56% in the state of Rio de Janeiro (AZEVEDO, 2008). The aim of this study was to describe the hepatobiliary ultrasound findings of cats infected with helminth. Coproparasitological examinations were performed for the detection of Platynosomun sp. eggs, which was found in thirteen of fourteen cats tested. Among the parasitized animals, one was Persian and twelve mixed breed cats, four females and nine males, and the age ranged from five months to eight years. The liver enzymes alanine transaminase (ALT), alkaline phosphatase (ALP) and gamma glutamyl transferase (GGT) were dosed and ultrasonographic examination of the hepatobiliary system of cats was performed. Two animals presented increased serum levels of ALT and none had alterations in ALP and GGT. Ultrasound findings were hepatomegaly (2/13), hypoechoic liver (3/13), heterogeneous ecotexture (3/13), gallbladder sediment (5/13), gallstone (1/13), thickening of the gallbladder wall (1/13), dilation of the cystic duct (7/13) and extrahepatic ducts (7/13), and one cat presented thickened and hyperechoic ducts walls. The mean volume of the gallbladder was 2.37 ml. The common bile duct was measured in 12 cats, presenting a mean of 3.1mm in diameter, with a range of 1.8 to 4.8 mm. Ultrasonographic examination detected hepatobiliary changes in most cats with platinosomosis. Only one animal did not present such findings, but had an elevation of the ALT serum levels. It is important to study platinossomosis, since it is one of the affections that can affect the liver and gallbladder of felines, being able to be the cause of cholangiocarcinomas. The ultrasound examination is of fundamental relevance for the early diagnosis of platinosomatosis.

Antimicrobial Resistance in Salmonella spp. isolated from cattle gallbladder slaughtered in the south of the state of Rio de Janeiro

Salmonella infections are an important cause of mortality and morbidity in cattle, and subclinically infected animals arefrequently found. The microorganism may exhibit multiple antibiotic resistance and may be able to survive in harsh environmentssuch as the gallbladder. Salmonella Multiple Antibiotic Resistance (MAR) was detected in bile and gallbladder epitheliumfrom cattle slaughtered in a plant in southern state of Rio de Janeiro, Brazil, under sanitary conditions. The frequency ofresistance to each drug was not significantly different between bile and epithelium, except in the case of cefotaxime, whichshowed increased resistance in the bile. Aztreonam was the most effective antibiotic for inhibiting strain growth. Since theresults showed Salmonella spp. strains resistant to twelve antimicrobials, it denotes an alarming risk, therefore in cases ofinvasive infections in both human and animals there will be reduction of therapeutic options against the pathogen.