Hérnia diafragmática peritôniopericárdica congênita em uma gata / Congenital peritoniopericardial diaphragmatic hernia in a female kitten

Background: Peritoneopericardial diaphragmatic hernia is a rare pathogenesis of congenital origin, which occurs due to a failure in the communication between the diaphragm and the pericardium during embryogenesis. Symptoms may be non-existent or non-specific, depending on the herniated organ involved and, in most cases, the diagnosis is incidental. Regarding the most indicated treatment, there are still divergences in the literature concerning the indication of conservative or surgical treatment. This study reports the case of a feline peritoneopericardial hernia, for which surgical correction was the treatment of choice. Case: A 3-month-old female kitten, no defined racial pattern, was referred to the Veterinary Hospital of the Federal Rural University of Pernambuco for treatment of a peritoneopericardial diaphragmatic hernia. This condition was diagnosed through radiographic examination after the patient having been submitted to pediatric castration and presented anesthetic complications in the transsurgery. Blood count, biochemical profile and Doppler echocardiogram were performed, which showed no significant changes. To obtain a better study and surgical planning, computed tomography was performed to observe the heart located cranially in the pericardial cavity. Caudally to the heart, hepatic parenchyma located in the pericardial cavity was observed; and hepatic vessels presenting slightly enlarged dimensions. These tomographic findings suggested peritoneopericardial diaphragmatic hernia; being the liver present in the pericardial cavity and signs of congestion in the hepatic parenchyma. Due to the likelihood of future worsening of the hernia, surgical correction was performed, with an abdominal midline incision in the preumbilical region to reposition the liver to its normal anatomy, followed by diaphragm reconstitution through a herniorrhaphy. After the surgical procedure, the patient was referred for observation in internment and, after 15 days, the skin sutures were removed. Complete correction of the hernial defect was observed on radiography performed 30 days after the surgical procedure. However, the examination showed the presence of deviation/ deformity in the topography of the sternum and costal cartilages, with slight cardiac displacement to the right hemithorax, suggesting the presence of pectus excavatum. Discussion: Peritoneopericardial diaphragmatic hernia is considered rare and, despite being one of the most common causes of congenital pericardial anomaly in felines, it has a low prevalence ranging from 0.06% to 1.45%. They are usually diagnosed from two years of age, with prevalence for older animals. However, due to having presented anesthetic changes, the patient of this case report could be diagnosed early. Among the most common organs that migrate to the thoracic cavity, the liver is the most commonly observed, which is also the hernia content of the present report. Peritoneopericardial hernia is often diagnosed through radiography and ultrasound, and these imaging tests proved to be sufficient for the diagnosis in this report. However, computed tomography was important for providing a better study of case and for the adoption of median celiotomy as a treatment. Associations with other malformations are described in the literature, with pectus excavatum being the most common and also observed in this report. Peritoneopericardial diaphragmatic hernia is a rare anomaly, rarely reported in the literature and with divergences regarding its treatment. The adoption of early surgical treatment performed in this report showed satisfactory evolution and the possibility of a favorable prognosis.

Primary pulmonary chondrosarcoma in a bitch

Background: Primary lung neoplasms are uncommon in veterinary medicine, and when they develop, they are more frequently observed to be of epithelial origin. Although chondrosarcomas are the second most diagnosed type of neoplasm in dogs at skeletal sites, their development in extraskeletal tissues, including the spleen, aorta, heart, tongue, peritoneum, and lungs, corresponds to approximately only 1% of cases. Therefore, the occurrence of primary pulmonary chondrosarcoma is considered very rare in domestic animals. Considering the rare occurrence and scarcity of data regarding its development, the present report describes the clinical and pathological aspects of a case of primary pulmonary chondrosarcoma in a bitch. Case: A 8-year-old mixed-breed bitch, weighing 14.2 kg, was examined at one private veterinary clinic with the principal complaint of prolonged respiratory distress and resistance to exercise. Clinical evaluation revealed tachypnea with expiratory dyspnea due to intense pleural effusion, tachycardia, and diffusely pale mucous membranes. Thoracocentesis was performed with drainage of 1000 mL of modified transudate, and fluid cytology, blood count, and chest radiography were performed. Cytological analysis of the thoracic fluid did not identify neoplastic cells, the blood count showed intense regenerative anemia, and the radiograph showed an extensive area of consolidation in the left caudal lung lobe, compatible with neoplasia. The results of the tests performed, in addition to the evolution of the clinical picture and the impossibility of performing the indicated surgical intervention, culminated in the patient's unfavorable prognosis, followed by euthanasia, necropsy, and histopathological evaluation of the collected material. Necropsy revealed a white neoplastic formation with reddish areas and firm consistency that diffused into the parenchyma of the left caudal lung lobe with invasion of the rib cage, fracture of the fifth and sixth left ribs, diaphragmatic metastasis, intense hydrothorax, and moderate hydroperitoneum. Microscopically, in the histological sections of the lung and diaphragm, poorly differentiated mesenchymal cells with moderate anisocytosis and anisokaryosis and interspersed with them, moderately differentiated chondrocytes surrounded by chondroid matrix, moderate anisocytosis and anisokaryosis, and a low mitotic index culminated in the diagnosis of primary pulmonary mesenchymal chondrosarcoma. Discussion: Malignant epithelial neoplasms were suspected; however, the histopathological features observed were compatible with primary pulmonary chondrosarcoma. The characteristics of the fluid collected through thoracentesis led to its classification as a modified transudate, which is often associated with neoplastic and hemorrhagic processes; both alterations were present in this case. The diagnosis of primary pulmonary chondrosarcoma was established based on the histopathological findings since the cell type and distribution observed in the present case were compatible with the typical pattern observed in extraskeletal chondrosarcomas. An unfavorable prognosis is common in cases of primary or metastatic lung neoplasm since, in most cases, the condition is identified in the advanced stages of the disease, making therapeutic management challenging. Given the increase in the number of dog deaths due to neoplasms in recent years, this case report may contribute to a better understanding of the biological behavior of pulmonary chondrosarcoma and assist in the choice of treatment to be adopted when required.

Extensive emphysematous pyelonephritis in a nondiabetic female cat - treatment with unilateral nephroureterectomy

Background: Emphysematous pyelonephritis (EPN) is an acute, severe necrotizing infection of the renal parenchyma and surrounding tissues that results in gas formation in the kidney, collecting system, or surroundings. EPN is a rare condition in veterinary medicine and occurs most frequently in dogs with diabetes mellitus. Although the prognosis of medical management in animals is poor, the standardized treatment protocol according to EPN severity is unclear. This report describes the first case of a nondiabetic female cat with extensive EPN and good prognosis following direct nephroureterectomy (NU). Case: A 10-year-old spayed female cat presented with the chief complaint of an acute loss of weight within 1 week, vomiting, and disorientation including stumbling, discoordination, circling, wobbling, head tilting, and difficulties in standing. At presentation, the patient had a body condition score of 1/9 and weighed 2.6 kg. Blood examination revealed leukocytosis, anemia, and hypoproteinemia. Abdominal radiography revealed severely decreased serosal details. A massive gas silhouette observed in the peritoneal and retroperitoneal cavities, was diagnosed as abdominal free gas. Abdominal ultrasound showed an accumulation of moderately anechoic fluid mixed with gas and cyst-like capsules around the left kidney. Left partial ureteral obstruction and dilation were also observed. Computed tomography (CT) was performed without sedatives or anesthetic drugs. The findings showed severe inflammatory changes in the peritoneum and a loss of the normal inner structure in the left kidney. A pyelogram of the left kidney was not observed after injection of the contrast material. Diffuse fat stranding and free gas observed in the mesentery of the entire abdominal cavity and around the left kidney were considered septic peritonitis. Urinalysis revealed proteinuria and hematuria. Numerous neutrophils with rod-type bacteria were observed in the ascites. Following diagnostic examinations, the patient was diagnosed with extensive left EPN, including inflammatory ascites and abdominal free gas. Therefore, emergency NU of the nonfunctional left kidney and ruptured ureter and thorough abdominal lavage were conducted. Diffuse inflammation and a nephrolith were observed in the section of the harvested kidney. The nephrolith was composed of 100% calcium oxalate monohydrate. The realtime polymerase chain reaction (RT-PCR) test for feline infectious peritonitis (FIP) was negative. Escherichia coli was detected in the ascites, and antibiotic therapy was administered following the antibiotic sensitivity test. The histological findings from the left kidney and ureter included marked chronic inflammation and fibrosis. The patient was discharged 4 days after surgery. During the 8-month follow-up period, the patient's condition improved. Discussion: This was a unique case of EPN in a nondiabetic cat and the first reported case of EPN with a ruptured ureter, including abdominal free gas, inflammatory ascites, and peritonitis. This patient had a bacterial urinary tract infection with E. coli, which is the most frequently isolated pathogen in humans. This gas-forming bacteria produced a massive amount of gas and inflammation that were considered to have ruptured the urinary tract, so that the gas was released into the abdomen. This case corresponded to class 3B, with two risk factors according to the human EPN classification system. Direct NU and abdominal lavage were performed as emergency surgeries. The patient stabilized gradually and showed a good prognosis. Immediate surgical intervention is recommended in animal patients showing the extensive EPN stage.

Gota úrica visceral em pato-do-mato (Cairina moschata) / Visceral uric gout in muscovy duck (Cairina moschata)

Background: Gout, a metabolic disease affecting multiple species, is frequent in birds which are uricotelic animals. It is primarily caused by hyperuricemia originating from birds' renal disorders with subsequent deposition of urate crystals into tissue. The location of the crystals determines the type of disease. Joint disease occurs with deposition inside and around joints, joint capsules, and tandine hems, while visceral disease occurs when the serous surface of visceral organs (mainly pericardium, liver, kidneys, air sacs, peritoneum, and spleen) are affected. This report describes a case of visceral uric gout in a Muscovy duck, which is rare. Case: An adult, male, Muscovy duck (Cairina moschata), kept under human care in a zoo, was referred to a veterinary clinic. The animal presented suddenly with prostration, ataxia, and anorexia, and died the following day. The body was sent to the Pathology Sector of Ritter dos Reis University Center (UniRitter) for a necropsy. During the necropsy, it was observed that white membranes, presenting a "chalk dust" appearance, were deposited under the serous layer of organs including the liver, kidneys, and pericardium. Following the necropsy and macroscopic evaluations, fragments of multiple organs were fixed in 10% formalin and processed routinely with hematoxylin and eosin (HE) staining for histopathological evaluation in an analysis laboratory in Porto Alegre city. A deposition of amorphous eosinophilic material was identified in the intestine, liver (serous), kidneys, lungs, and heart (epicardium) with findings of serositis, nephritis, and fibrinous epicarditis. The liver parenchyma and lungs had areas of congestion. There was both moderate and intense hepatocellular degeneration as well as degeneration in the renal tubular cells. These macro and microscopic changes were compatible with urate crystal deposition which represents visceral uric gout. Discussion: As opposed to free-living birds, birds in captivity have easy access to food and are sedentary. These factors, together with inadequate food management, make nutritional disorders the main predisposing cause of uric gout in these animals. Since it was not possible to determine the causative factors of this individual animal's disease due to the absence of examinations while alive, a nutritional origin of this animal's demise was considered. According to prior reports, an important cause of avian disease can be attributed directly or indirectly to kidney dysfunction. In addition to a deposition of amorphous material in the renal cortex, this Muscovy duck had areas of tubular cell degeneration and proliferation of fibrous connective tissue. However, it was not possible to establish a cause and effect relationship between the renal damage and the uric gout. Despite being common in birds under human care, the disease still is challenging for veterinarians, since the diagnosis is often late and treatment is often ineffective. The absence of documentation of this disease in the Muscovy duck contributes to the difficulty in establishing predisposing factors and a distinct disease etiology. This highlights the importance of the present report and the need for new studies. To the best of our knowledge, this is the first report of visceral uric gout in a Muscovy duck (Cairina moschata). This highlights the importance of necroscopic examinations and the impact they can have in the clinical arena, especially in wild animals.

Mesotelioma peritoneal em onça-pintada (Panthera onca Linnaeus, 1758) / Peritoneal mesothelioma in jaguar (Panthera onca Linnaeus, 1758) / Mesotelioma peritoneal en jaguar (Panthera onca Linnaeus, 1758)

Mesoteliomas são neoplasias malignas que causam lesões graves e extensas em peritônio, pleura, pericárdio e órgãos adjacentes. O presente estudo de caso discorre sobre o óbito de uma onça-pintada (Panthera onca) mantida sob cuidados humanos em um zoológico do estado de São Paulo, com idade estimada de 19 anos, que apresentou aumento de volume abdominal, ascite, diminuição de deslocamento pelo recinto, inapetência e polidipsia. O paciente foi submetido a exames clínicos, laboratoriais e de diagnósticos por imagem, e em curto espaço de tempo foi a óbito. Os resultados anatomopatológicos e imuno-histoquímicos indicaram o diagnóstico conclusivo de mesotelioma peritoneal, com metástase em linfonodo mesenterico.(AU)

Mesotheliomas are malignant neoplasms and cause severe and extensive lesions in the peritoneum, pleura, pericardium and adjacent organs. The present case study discusses the death of a jaguar (Panthera onca) kept under human care in a zoo in the state of São Paulo, Brazil, with an estimated age of 19-years-old. He presented increased abdominal volume, ascites, decreased displacement by the enclosure, inappetence and polydipsia. The patient underwent clinical, laboratory and diagnostic imaging tests and died after a short period of time. The anatomopathological results indicated the diagnosis of peritoneal mesothelioma, with metastasis in the mesenteric lymph node.(AU)

Los mesoteliomas son neoplasias malignas y provocan lesiones graves y extensas en el peritoneo, pleura, pericardio y órganos adyacentes. El presente estudio de caso presenta la muerte de un jaguar (Panthera onca) mantenido bajo cuidado humano en un zoológico en el estado de São Paulo, Brasil, con una edad estimada de 19 años. El animal presentó aumento de volumen abdominal, ascitis, disminución del desplazamiento por el recinto, inapetencia y polidipsia. Al paciente se le realizaron pruebas clínicas, de laboratorio y de diagnóstico por imágenes, pero en poco tiempo falleció. Los resultados anatomopatológicos indicaron el diagnóstico de mesotelioma peritoneal, con metástasis en el ganglio mesenterico.(AU)

Incisional hernia repair in rats: description of the sublay technique under videomagnification system

Purpose: To describe the technique of sublay correction of incisional hernia in Wistar rats under videomagnification system. Methods: Five male rats of the species Rattus norvegicus, of the Wistar lineage, with body weight between 250­350 g and 60 days old were used. Incisional hernia was inducted in all animals. After that, the incisional hernia was immediately corrected by the sublay method. Results: There were no cases of recurrence of the incisional hernia after placement of the polypropylene mesh using the sublay technique. No postoperative complications were observed. Conclusions: The technique is suitable for execution in Wistar rats.

Bloqueio do plano transverso do abdômen em coelha submetida à mastectomia e ovariohisterectomia / Blockade of the transverse plane of the abdomen in a rabbit submitted to mastectomy and ovariohysterectomy

Os bloqueios locorregionais vêm sendo cada vez mais estudados na medicina veterinária, principalmente em pets não-convencionais e animais silvestres. O bloqueio do plano transverso do abdômen (TAP block) é uma técnica de anestesia locorregional capaz de promover anestesia e analgesia em regiões da pele, musculatura e peritônio parietal, as quais fazem parte da estratégia de analgesia multimodal. O objetivo deste trabalho é relatar o bloqueio do plano transverso em um coelho doméstico de quatro anos de idade submetido à mastectomia regional e ovariohisterectomia. Foram realizados dois pontos bilateralmente de bloqueio do espaço TAP guiado por ultrassom com 2mg/kg de bupivacaína a 0,25%, padronizando um volume total injetado de 2,4mL. Foram utilizados dexmedetomidina (5É¥g/kg) e midazolam (0,5mg/kg) por via intramuscular como medicação pré-anestésica, indução com isoflurano na máscara de oxigênio 100% e manutenção por anestesia inalatória com isoflurano. Os parâmetros fisiológicos mantiveram-se estáveis, sem necessidade de resgate analgésico, com extubação rápida e despertar tranquilo. Desta forma, conclui-se que o TAP block foi eficaz na analgesia para mastectomia regional e ovariohisterectomia como protocolo multimodal, aumentando o índice de segurança, além de ser de fácil execução mesmo com transdutores de baixa frequência.

The locoregional blocks have been increasingly studied in veterinary medicine, especially in non-conventional pets and wild animals. The transverse abdominis plane block (TAP block) is a locoregional anesthesia technique capable of promoting anesthesia and analgesia in the skin, muscle, and parietal peritoneum regions, which are is part of the multimodal analgesia strategy. This study aims to report the transverse plane block in a four-year-old domestic rabbit submitted to regional mastectomy and ovariohysterectomy. Two ultrasound-guided TAP space blocks were performed bilaterally with 2mg/kg of bupivacaine 0.25%, standardizing a total injected volume of 2.4mL. Dexmedetomidine (5É¥g/kg) and midazolam (0.5mg/kg) were used intramuscularly as pre-anesthetic medication, induction with isoflurane in a 100% oxygen mask, and maintenance by inhalation anesthesia with isoflurane. Physiological parameters remained stable, with no need for analgesic rescue, rapid extubation, and peaceful awakening. Thus, it is concluded that the TAP block was effective in analgesia for regional mastectomy and ovariohysterectomy as a multimodal protocol, increasing the safety index. Moreover, it is easy to perform even with low-frequency transducers.

Peritoneal cryptococcosis in a dog

Background: Cryptococcosis is an opportunistic, systemic mycotic disease caused by yeasts of genus Cryptococcus.Cryptococcus neoformans might cause serious public health problems, as they can be transmitted to humans, domesticand wild animals. In cats and dogs, the main site of infection is the upper lower respiratory tract, however, the infectioncan extend and affect other sites in the organism, however, the peritoneal manifestation of the disease is rare. Thus, thepresent work aims to report a case of cryptococcosis in a canine, mixed breed, female, adult, from the Metropolitan Regionof Belém, PA, Brazil.Case: A mixed breed dog, female, adult was admitted in a veterinary hospital at Belém, presenting abdominal discomfortand, after the clinical examination, emergency exploratory laparotomy was indicated, and it were observed disseminatedlesions in the abdominal cavity, with multiple nodules attached to the peritoneum and intestinal serosa and bladder, uterus,among other organs. Fragments from the surgical biopsy were fixed, and processed routinely according to the techniquesfor histological tissue processing. Histological examination revealed a predominance of granulomatous lesions in peritoneum and mesentery organs. It was observed a discrete inflammatory reaction of macrophages, epithelioid cells andgiant cells, many in phagocytosis of spherical or ovoid organisms, with a thick capsule and a clear perinuclear halo. Inthe PAS staining, the Cryptococcus conidia presented eosinophilic characteristics and some of them had the capsule welldemarcated, which was shown to be radiated. Also it was possible to see the budding yeast and in the Grocott stain, theCryptococcus stained in black.Discussion: Cryptococcosis with peritoneal involvement in animals is rarely reported in the literature. Cryptococcus is afungus that presents tropism by the...

Peritoneal cryptococcosis in a dog

Background: Cryptococcosis is an opportunistic, systemic mycotic disease caused by yeasts of genus Cryptococcus.Cryptococcus neoformans might cause serious public health problems, as they can be transmitted to humans, domesticand wild animals. In cats and dogs, the main site of infection is the upper lower respiratory tract, however, the infectioncan extend and affect other sites in the organism, however, the peritoneal manifestation of the disease is rare. Thus, thepresent work aims to report a case of cryptococcosis in a canine, mixed breed, female, adult, from the Metropolitan Regionof Belém, PA, Brazil.Case: A mixed breed dog, female, adult was admitted in a veterinary hospital at Belém, presenting abdominal discomfortand, after the clinical examination, emergency exploratory laparotomy was indicated, and it were observed disseminatedlesions in the abdominal cavity, with multiple nodules attached to the peritoneum and intestinal serosa and bladder, uterus,among other organs. Fragments from the surgical biopsy were fixed, and processed routinely according to the techniquesfor histological tissue processing. Histological examination revealed a predominance of granulomatous lesions in peritoneum and mesentery organs. It was observed a discrete inflammatory reaction of macrophages, epithelioid cells andgiant cells, many in phagocytosis of spherical or ovoid organisms, with a thick capsule and a clear perinuclear halo. Inthe PAS staining, the Cryptococcus conidia presented eosinophilic characteristics and some of them had the capsule welldemarcated, which was shown to be radiated. Also it was possible to see the budding yeast and in the Grocott stain, theCryptococcus stained in black.Discussion: Cryptococcosis with peritoneal involvement in animals is rarely reported in the literature. Cryptococcus is afungus that presents tropism by the...(AU)

Training model in abdominal wall endoscopic surgery for ventral hernias. Extended totally extra-peritoneal approach (e-tep)

ABSTRACT Purpose: To develop a reproducible training program model covering the steps of the extended totally extraperitoneal approach (e-tep) technique for correction of ventral or incisional hernia repair. Methods: Training sessions with surgeons in the laboratory using both porcine specimens and a new ethylene vinyl acetate (EVA) model simulating the operative steps of the e-tep technique. Students were interviewed and asked to answer a questionnaire pre and post the sessions to assess their performance and evaluated the course and model. Results: A total of 25 trained abdominal wall surgeons was evaluated at the end of the course. It was obtained a 100% satisfaction score of the training, as well as increased confidence levels up to 9 and 10 in all technical aspects of the surgery, having 96% of the surgeons performed a surgery under supervision of the proctors after the course. Conclusions: This training model is simple, effective, low cost, and replicable in guidance on the beginning of e-tep technique adoption, and performance. As a result, surgeons can get more confident and more able to perform surgeries employing this technique.

Hérnia diafragmática peritoneopericárdica em um felino da raça Persa / Peritoneopericardial diaphragmatic hernia in a Persian cat

Background: Peritoneopericardial diaphragmatic hernia is a congenital defect characterized by an anomalous communication between the abdominal cavity and pericardial sac, which can lead to displacement of the abdominal viscera into the thoracic cavity. The occurrence in felines is higher among long-haired breeds, mainly the Persian breed, possibly based onan autosomal recessive inheritance. The diagnosis of PPDH is performed by means of chest radiography with or without contrast, in association with other imaging tests such as ultrasonography and echocardiography. Our objective in this study was to report the occurrence and macroscopic changes in a case of peritoneopericardial diaphragmatic hernia in a Persian feline. Case: A 9-year-old male Persian cat weighing 3.4 kg was referred to the HPET-Private Veterinary Clinic, Salvador, Bahia, with an history of weight loss and chronic intermittent vomiting during the preceding 6 months, with lateral decubitus and breathing difficulties. Ultrasonography revealed findings suggestive of an infiltrative process in the stomach and duodenum, enlarged gastric lymph nodes, and some nodular images indicating slight displacement of the liver. Chest radiography revealed a cardiac silhouette with markedly enlarged dimensions associated with a dorsal deviation of the terminal trachea, and echocardiography revealed a small amount of pericardial effusion. The patient showed initial clinical improvement after blood transfusion; however, after 2 days, he exhibited significant clinical worsening and was therefore euthanized with the owner's consent. Post mortem evaluation revealed partial herniation of the liver and gallbladder into the chest cavity through a diaphragmatic hernia ring. The heart was partially surrounded by the left medial lobe of the liver, which was displaced into the pericardial sac. Herniated hepatic lobes had an irregular capsular surface with evident lobulation and tension lipidosis. In the abdominal cavity, the remainder of the liver (right lateral and medial lobes) was observed to be slightly enlarged, with an irregular surface, diffusely reddish with intense evidence of the lobular pattern and white and firm multifocal areas (fibrosis). In the duodenum, close to the pylorus, there was a nodule measuring 2.8 x 2.5 x 1.0 cm, with a whitish and ulcerated surface. When cut, it was soft and exhibited a homogeneous, whitish compact surface. Histopathological examinationshowed marked proliferation of fibrous connective tissue, which for the most part separated the lobes by septa and surrounded the portal space (fibrosis), a marked diffuse chronic inflammatory infiltrate composed of lymphocytes and plasma cells. In addition, marked bile duct hyperplasia and multifocal areas of fatty degeneration (steatosis). Discussion: The diagnosis was based on the association of clinical and pathological findings. Considering the age and clinical signs presented by the patient in this report, as well as the presence of few radiographic signs that were indicative of PPDH, the first differential diagnosis thought was pericardial neoplasia. Peritoneopericardial diaphragmatic hernia in felines is always of congenital origin and may occur asymptomatically depending on the number and involvement of herniated viscera. In this case, the patient's diagnosis of peritoneopericardial hernia was a necropsy finding; the fact that in agreement with previous reports of high rates of incidental diagnoses reinforces the importance of performing necropsy for confirmation or diagnosis of unexpected pathologies. In the present case, peritoneopericardial diaphragmatic hernia in isolation may not have led to severe anemia that culminated in the patient's death. The anatomopathological findings were compatible with biliary cirrhosis and multifocal liver fibrosis, accompanied by the presence of anemia and consequent hypovolemia.

Simulated training model in a low cost for laparoscopic inguinal hernioplasty

Purpose Develop a 3D model for the simulation of laparoscopic inguinal hernioplasty transabdominal preperitoneal (TAPP). Methods This is an experimental study, 18 participants were selected, divided into three groups, experimental (GE) surgeons in training, control (GC) experienced surgeons and Shaw (GS) nonexperienced surgeons. The simulation in the 3D model was carried out in 6 sessions fulfilling the 5 stages. Opening the peritoneum with the creation of the preperitoneal space; identification of important structures; hernia identification and reduction; placement and fixation of the mesh in Coopers ligament and closure of the peritoneum. Results In the 1st stage, the GE obtained an average of 1.25 ± 0.42 in the 1st session and 3.25 ± 0.62 in the 6th session (p = 0.05) and in the 5th stage 0.91 ± 0.29 in the first session. 1st session and 1.91 ± 0.29 in the 6th session (p = 0.001), with no significant difference between groups. The learning and skill curve in the SG represented 1.08 ± 0.29 1st and 3.50 ± 0.90 6th session (p = 0.001). Conclusions The creation of a systematization of training in simulation applied to the three-dimensional model enabled gain in laparoscopic skills and underpinned its theoretical and practical foundations.(AU)

Bovine tunica albuginea conserved in honey as xenograft for cystoplasty in rats / Túnica albugínea bovina conservada em mel como xenoenxerto na cistoplastia em ratos

ABSTRACT: Urinary bladder damages leading to few viable bladder tissue available might demand a challenging reconstructive surgery. In this context, biomaterials are valid alternatives for bladder reconstruction. This study evaluated the bovine tunica albuginea fragment as graft material for cystoplasty in rats and honey-preserved implant viability.Thirty Wistar rats were assigned to two groups: (1) a test group (T) with a circular 1.0-cm-diameterbovine tunica albuginea graft application in the apex region by a continuous absorbable (Polyglactin 910 5-0) suture with stitching of all bladder layers and (2) a simulation group (S) in which animals underwent only partial cystectomy. In addition, each of these groups was further divided into three subgroups according to euthanasia period on post-surgery day 7, 15 and 30.Two animals had self-limiting hematuria at postsurgical period. At necropsy, frequent crystals and adhesion to the peritoneum were observed. At the histopathological evaluation, animals from the T group euthanized by 15th postoperative day had layers disorganization and initial muscle development, while T group rats euthanized by 30th postoperative day showed complete urothelization. Urothelization pattern was similar in both groups. Moreover, the muscular layer formation was present in both groups, but more evident in S group animals. Nevertheless, inflammatory infiltrate and neovascularization were remarkably more intense in T group rats.It might be concluded that bovine tunica albuginea graft was successful in repairing rats' bladder, being a good biomaterial option in reconstructive urinary vesicle surgery.

RESUMO: Lesões na vesícula urinária que culminem em pouco tecido vesical viável podem demandar cirurgias reconstrutivas desafiadoras. Neste contexto, biomateriais são alternativas válidas para a reconstrução da bexiga. O objetivo deste trabalho foi avaliar a túnica albugínea bovina como material para enxerto na cistoplastia em ratos, assim como a viabilidade deste implante preservado em mel. Trinta ratos Wistar foram divididos em dois grupos: (1) um grupo teste (T), no qual os animais foram submetidos a cistectomia parcial seguida de cistoplastia com aplicação do enxerto circular com 1,0cm de diâmetro de túnica albugínea bovina na região do ápice com sutura absorvível (Poliglactina 910 5-0) em padrão contínuo englobando todas as camadas da bexiga; e (2) um grupo simulação (S), cujos ratos realizaram apenas cistectomia parcial. Além disso, cada grupo foi posteriormente dividido em três subgrupos de acordo com a data de eutanásia no dia 7, 15 ou 30 de pós-operatório.Dois animais apresentaram hematúria autolimitante no período de observação pós-operatória. Na necrópsia, notaram-se cristais frequentes e aderências entre bexiga e peritônio. Na avaliação histopatológica, animais do grupo T eutanasiados com 15 dias de pós-operatório apresentavam camadas vesicais desorganizadas e formação de musculatura inicial na bexiga, enquanto aqueles eutanasiados com 30 dias de cirurgia mostraram urotelização completa. O padrão de urotelização foi semelhante nos dois grupos. Além disso, a formação da camada muscular esteve presente em ambos os grupos, porém mais evidente nos animais do grupo S. No entanto, o infiltrado inflamatório bem como a neovascularização foram notavelmente mais intensos nos ratos do grupo T.Pode-se concluir que o enxerto de túnica albugínea bovina foi bem sucedido no reparo da vesícula urinária de ratos, demonstrando ser uma boa opção de biomaterial para cirurgias reconstrutivas da vesícula urinária.

Techniques of orthotopic renal transplantation. II. Size-matched porcine grafts in monkey recipients

ABSTRACT Purpose As a classical xenotransplantation model, porcine kidneys have been transplanted into the lower abdomen of non-human primates. However, we have improved upon this model by using size-matched grafting in the orthotopic position. The beneficial aspects and surgical details of our method are reported herein. Methods Donors were two newborn pigs (weighting 5 to 6 kg) and recipients were two cynomolgus monkeys (weighting, approximately, 7 kg). After bilateral nephrectomy, kidneys were cold-transported in Euro-Collins solution. The porcine kidney was transplanted to the site of a left nephrectomy and fixed to the peritoneum. Results Kidneys transplanted to the lower abdomen by the conventional method were more susceptible to torsion of the renal vein (two cases). In contrast, early-stage blood flow insufficiency did not occur in orthotopic transplants of theleft kidney. Conclusions Size-matched porcine-primate renal grafting using our method of transplanting tothe natural position of the kidneys contributes to stable post-transplant blood flow to the kidney.

Mesotelioma peritoneal epitelioide papilar maligno em bovino gir – Relato de caso / Malignant papillary epitelioid mesothelioma in the peritoneal cavity of a gir cattle – Case report

O objetivo deste trabalho foi relatar um caso de mesotelioma peritoneal epitelioide papilar em um bovino. Foi atendida uma vaca Gir, com dez anos de idade, apresentando taquicardia, taquipneia, 8% de desidratação, hipomotilidade ruminal, edema de barbela e aumento da circunferência abdominal bilateral ventral. Os achados de palpação consistiram na presença de múltiplos nódulos abdominais firmes, de tamanhos variados, localizados na parede abdominal e presença de grande quantidade de líquido intra-abdominal, confirmados pela ultrassonografia transretal. O líquido peritoneal coletado foi classificado como transudato modificado. Foi realizada laparotomia exploratória pelo flanco, identificando-se aproximadamente 150 litros de líquido peritoneal e múltiplos nódulos de coloração esbranquiçada, firmes, irregulares e difusos no peritônio e na superfície serosa de diferentes órgãos. O exame histopatológico dos fragmentos coletados por biopsia confirmou o diagnóstico de mesotelioma peritoneal classificado como sendo do tipo epitelioide papilar. A maioria dos casos de mesotelioma ocorre de forma incidiosa e sua manifestação clínica ocorre em quadros mais avançados, quando o prognóstico se torna desfavorável ao animal. A partir das condições encontradas no presente relato, foi indicada eutanásia do animal em razão do comprometimento do bem-estar.

The aim of this paper was to report a case of papillary epithelial mesothelioma of the peritoneal surface in a cattle. A ten-yearold Gir cow was examined on a rural property, presenting tachycardia, tachypnea, 8% dehydration, ruminal hypomotility submandibular edema and bilateral ventral abdominal enlargement. Rectal palpation showed multiple firm abdominal nodules, of varying sizes, located in the abdominal wall and the presence of large amounts of intra-abdominal fluid, confirmed by transrectal ultrasonography. The peritoneal fluid collected was classified as modified transudate. Exploratory laparotomy was performed along the flank, identifying approximately 150 liters of peritoneal fluid and multiple whitish-colored nodules, firm, irregular and diffuse on the peritoneum and on the serous surface of different organs. Histopathological examination of the biopsy pieces confirmed the diagnosis of peritoneal mesothelioma classified as papillary epithelioid type. Most cases of mesothelioma occur insidious, and its clinical manifestation occurs in more advanced cases, when the prognosis becomes unfavorable for the animal. Based on the conditions found in this report, euthanasia of the animal was indicated due to compromised well-being.

Incisional hernia in a dog

Background: The rupture of the suture in the abdominal wall, but with integrity of the cutaneous suture, results in a condition known as incisional hernia. It is characterized by the protrusion of the abdominal viscera through orifices or areas ofthe abdominal wall. In most of the cases these defects in the abdominal wall are iatrogenic. The incisional hernia occursin an intact wall that is weakened by surgical incisions. The available literature on the incidence of incisional herniasin animals is scarce. With the aim to contribute to the information about incisional hernia in animals, it was decided todescribe the case of incisional hernia in a female dog after performing ovariohysterectomy (OH).Case: An adult mongrel shelter bitch, of unknown age, weighing 9.5 kg was admitted for OH in a practical class of theveterinary surgical technical discipline. Once the anesthetic condition was established, a retro-umbilical cutaneous incisionwas made. After opening the abdominal cavity, the bitch was castrated routinely. The abdominal wall was sutured including peritoneum, muscle fascia, and rectus abdominis muscle with nylon thread and U-stitches. The subcutaneous tissuewas then sutured with the same thread using Cushing suture. Ten days after the surgery, when the stitches were removed,the bitch revealed an increase in volume at the region of the surgical scar. Incisional hernia was diagnosed after carefulpalpation. For correction of the hernia, the bitch was submitted to surgical procedure. After the skin opening, an intenseinflammatory reaction was observed in the subcutaneous tissue. The inflamed skin and subcutaneous tissue were removed.The abdominal cavity was closed with nylon thread by means of U-stitches. The subcutaneous and skin...

Peritonitis and necrotizing hepatitis in Ara ararauna caused by a foreign body

Background: The ingestion of foreign bodies in parrots has already been described and associated with the curious behaviorof the birds or with stressful conditions. Foreign bodies in the gastrointestinal tract are usually diagnosed through clinicalsigns, laboratory tests, and radiographic findings in the historical data. Foreign bodies are usually metallic and can lodgein any segment of the gastrointestinal tract, commonly found in the proventricle and gizzard. This study investigated acase of necrotizing hepatitis due to a foreign body in Ara ararauna (Linnaeus, 1758).Case: An approximately 9-month-old specimen of caninde macaw, had sudden death and was referred for autopsy. Themacroscopic examination revealed a fibrous, thick, reddish membrane involving the left hepatic lobe and partially the gizzard in continuity with the peritoneum. Inside the capsule, the liver had a friable and necrotic appearance and the gizzardhad a focal perforation area containing a foreign body (gavage tube feeding). We performed the histopathological examination of the liver and gizzard and observed that the membrane surrounding the liver and partially the gizzard had a chronicinflammatory process with a marked proliferation of fibrous tissue and fibrin deposition. The hepatic parenchyma of theleft lobe showed diffuse and marked necrosis, with signs of ischemic necrosis. In the region of transmural perforation ofthe gizzard, the mucosa showed a focal area of extensive necrosis accompanied by the presence of intralesional bacteria.The lesions observed are attributed to the perforation of the organs by the foreign body. It is not known whether the birdingested the object accidently during food handling as a young or due to the curious behavior of the bird or even the stressit may have been exposed to. The post mortem examination revealed localized peritonitis...

Mesotelioma peritoneal epitelioide papilar maligno em bovino gir Relato de caso / Malignant papillary epitelioid mesothelioma in the peritoneal cavity of a gir cattle Case report

O objetivo deste trabalho foi relatar um caso de mesotelioma peritoneal epitelioide papilar em um bovino. Foi atendida uma vaca Gir, com dez anos de idade, apresentando taquicardia, taquipneia, 8% de desidratação, hipomotilidade ruminal, edema de barbela e aumento da circunferência abdominal bilateral ventral. Os achados de palpação consistiram na presença de múltiplos nódulos abdominais firmes, de tamanhos variados, localizados na parede abdominal e presença de grande quantidade de líquido intra-abdominal, confirmados pela ultrassonografia transretal. O líquido peritoneal coletado foi classificado como transudato modificado. Foi realizada laparotomia exploratória pelo flanco, identificando-se aproximadamente 150 litros de líquido peritoneal e múltiplos nódulos de coloração esbranquiçada, firmes, irregulares e difusos no peritônio e na superfície serosa de diferentes órgãos. O exame histopatológico dos fragmentos coletados por biopsia confirmou o diagnóstico de mesotelioma peritoneal classificado como sendo do tipo epitelioide papilar. A maioria dos casos de mesotelioma ocorre de forma incidiosa e sua manifestação clínica ocorre em quadros mais avançados, quando o prognóstico se torna desfavorável ao animal. A partir das condições encontradas no presente relato, foi indicada eutanásia do animal em razão do comprometimento do bem-estar.(AU)

The aim of this paper was to report a case of papillary epithelial mesothelioma of the peritoneal surface in a cattle. A ten-yearold Gir cow was examined on a rural property, presenting tachycardia, tachypnea, 8% dehydration, ruminal hypomotility submandibular edema and bilateral ventral abdominal enlargement. Rectal palpation showed multiple firm abdominal nodules, of varying sizes, located in the abdominal wall and the presence of large amounts of intra-abdominal fluid, confirmed by transrectal ultrasonography. The peritoneal fluid collected was classified as modified transudate. Exploratory laparotomy was performed along the flank, identifying approximately 150 liters of peritoneal fluid and multiple whitish-colored nodules, firm, irregular and diffuse on the peritoneum and on the serous surface of different organs. Histopathological examination of the biopsy pieces confirmed the diagnosis of peritoneal mesothelioma classified as papillary epithelioid type. Most cases of mesothelioma occur insidious, and its clinical manifestation occurs in more advanced cases, when the prognosis becomes unfavorable for the animal. Based on the conditions found in this report, euthanasia of the animal was indicated due to compromised well-being.(AU)

Peritonitis and necrotizing hepatitis in Ara ararauna caused by a foreign body

Background: The ingestion of foreign bodies in parrots has already been described and associated with the curious behaviorof the birds or with stressful conditions. Foreign bodies in the gastrointestinal tract are usually diagnosed through clinicalsigns, laboratory tests, and radiographic findings in the historical data. Foreign bodies are usually metallic and can lodgein any segment of the gastrointestinal tract, commonly found in the proventricle and gizzard. This study investigated acase of necrotizing hepatitis due to a foreign body in Ara ararauna (Linnaeus, 1758).Case: An approximately 9-month-old specimen of caninde macaw, had sudden death and was referred for autopsy. Themacroscopic examination revealed a fibrous, thick, reddish membrane involving the left hepatic lobe and partially the gizzard in continuity with the peritoneum. Inside the capsule, the liver had a friable and necrotic appearance and the gizzardhad a focal perforation area containing a foreign body (gavage tube feeding). We performed the histopathological examination of the liver and gizzard and observed that the membrane surrounding the liver and partially the gizzard had a chronicinflammatory process with a marked proliferation of fibrous tissue and fibrin deposition. The hepatic parenchyma of theleft lobe showed diffuse and marked necrosis, with signs of ischemic necrosis. In the region of transmural perforation ofthe gizzard, the mucosa showed a focal area of extensive necrosis accompanied by the presence of intralesional bacteria.The lesions observed are attributed to the perforation of the organs by the foreign body. It is not known whether the birdingested the object accidently during food handling as a young or due to the curious behavior of the bird or even the stressit may have been exposed to. The post mortem examination revealed localized peritonitis...(AU)

Incisional hernia in a dog

Background: The rupture of the suture in the abdominal wall, but with integrity of the cutaneous suture, results in a condition known as incisional hernia. It is characterized by the protrusion of the abdominal viscera through orifices or areas ofthe abdominal wall. In most of the cases these defects in the abdominal wall are iatrogenic. The incisional hernia occursin an intact wall that is weakened by surgical incisions. The available literature on the incidence of incisional herniasin animals is scarce. With the aim to contribute to the information about incisional hernia in animals, it was decided todescribe the case of incisional hernia in a female dog after performing ovariohysterectomy (OH).Case: An adult mongrel shelter bitch, of unknown age, weighing 9.5 kg was admitted for OH in a practical class of theveterinary surgical technical discipline. Once the anesthetic condition was established, a retro-umbilical cutaneous incisionwas made. After opening the abdominal cavity, the bitch was castrated routinely. The abdominal wall was sutured including peritoneum, muscle fascia, and rectus abdominis muscle with nylon thread and U-stitches. The subcutaneous tissuewas then sutured with the same thread using Cushing suture. Ten days after the surgery, when the stitches were removed,the bitch revealed an increase in volume at the region of the surgical scar. Incisional hernia was diagnosed after carefulpalpation. For correction of the hernia, the bitch was submitted to surgical procedure. After the skin opening, an intenseinflammatory reaction was observed in the subcutaneous tissue. The inflamed skin and subcutaneous tissue were removed.The abdominal cavity was closed with nylon thread by means of U-stitches. The subcutaneous and skin...(AU)