Resumo
Purpose: Research in high-income countries has extensively documented the non-operative management of spleen injuries in children, resulting in low splenectomy rates (5%). However, there is a lack of literature on this topic in low- and-middle-income countries (LMICs), including Brazil. This scoping review analyzed pediatric spleen trauma research trends in Brazil and the United States of America (USA). Methods: Search strategy was conducted across five databases, considering articles published in English or Portuguese from January 1968 to 2023 that reported spleen injury in patients younger than 18 years old in Brazil or the USA. Two pairs of independent reviewers screened the title and the abstract, followed by a full-text review. Results: The total of 7,150 studies was identified, of which 295 were eligible for data extraction. Most papers (98.64%, 301) originated from the USA, while only 1.36% (4) were from Brazil. In addition, 46.44% (137) articles reported intrabdominal injury, including splenic trauma, 16.27% (48) liver and spleen injury, and 37.29% (110) reported isolated spleen injury. The operative rate for spleen injury was 11.33% in American studies (40,812/359,926) compared to 98.57% (137/139) in Brazilian studies. Conclusions: Brazil contributed only with four studies on pediatric splenic trauma over two decades. Future studies should explore the incidence and management of splenic trauma in LMICs.
Assuntos
Pediatria , Baço , Ferimentos e Lesões , Saúde GlobalResumo
Background: Leiomyosarcoma is a malignant mesenchymal neoplasm that commonly occurs in the uterus and gastrointestinal tract. Its primary occurrence in the spleen is considered rare, corresponding to only 4% of cases. The diagnosis must be made based on the patient's medical history, clinical signs and complementary exams. The gold standard test for a definitive diagnosis is immunohistochemistry. This paper reports a case of one dog suffering from primary splenic leiomyosarcoma, emphasizing the importance of the immunohistochemical exam to conclude the diagnosis and select an ideal treatment. Case: A 10-year-old male Labrador dog, was treated after presenting for 4 days with hyporexia, constipation and sporadic cases of emesis. A physical examination of the patient revealed a body condition score of 9, with 1 being extremely thin and 9 being obese, abdominal pain during palpation, 5% dehydration, apathy and a slightly distended abdomen. Radiographic and ultrasound exams were requested to evaluate the thoracic and abdominal organs. In view of the results, the patient was referred to hospital for hydration, followed by a median celiotomy and orchiectomy. Blood count and serum biochemistry were requested as preoperative exams. In a laboratory evaluation, the animal's blood count revealed normochromic normocytic anemia, thrombocytosis, high levels of total plasma protein and neutrophilia. The patient's serum biochemistry profile indicated an increase in the enzyme activity of aminotransferase (AST), alkaline phosphatase (AP) and urea. An ultrasound exam revealed a 7.03 x 7.86 cm coarse-textured mass in the spleen. Right lateral view chest X-rays showed diaphragmatic compression by a round radiopaque structure projecting cranially, surpassing the 7th intercostal space, while the thoracic ventral-dorsal projection revealed absence of radiographic findings suggestive of pulmonary nodules or masses. The histopathological examination performed after total removal of the mass revealed moderately differentiated myofibroblastic sarcoma. However, an immunohistochemical test to confirm the diagnosis revealed immunoreactivity to vimentin (V9) and smooth muscle actin (1A4), conclusive for leiomyosarcoma. Discussion: Leiomyosarcoma typically develops silently, without displaying clinical signs or presenting nonspecific clinical signs, depending on its location. Patients with stromal tumors may present with anorexia, vomiting, polydipsia, lethargy, weakness, weight loss, enlarged abdomen and abdominal pain, which partially coincides with this case. In addition, enlarged spleen size may lead to displacement of adjacent viscera, causing signs of abdominal pain, vomiting and constipation, which coincide with the case in question. Leiomyosarcoma can be diagnosed based on the patient's medical history, physical examination and complementary tests, particularly immunohistochemistry, which proved to be of paramount importance for the definitive diagnosis of this patient. Changes in laboratory test results are a consequence of the neoplasm, its localization, and the patient's clinical status. In cases of neoplasia, surgical resection is a long-standing procedure that is efficacious in halting tumor growth. Moreover, the proposal of total splenectomy is based on the level of impairment of the organ by the mass. Given the difficulty in assessing its histogenesis, immunohistochemistry testing proved to be necessary to confirm the diagnosis, showing neoplastic cells immunoreactive to vimentin and actin, and positive for cell proliferation antigen, enabling the diagnosis of leiomyosarcoma.
Assuntos
Animais , Masculino , Cães , Baço/patologia , Neoplasias Esplênicas/veterinária , Células Estromais/patologia , Leiomiossarcoma/veterinária , Imuno-Histoquímica/veterináriaResumo
Background: A 10-year-old spayed bitch with hip dysplasia was referred for periarticular ultrasound evaluation. A poorly marginated structure of mixed echogenicity, predominantly hypoechoic, with heterogeneous echotexture, was identified in the vastus lateralis muscle of the right pelvic limb with increased stiffness, assessed using acoustic radiation force impulse (ARFI) elastography, compared to that of the adjacent muscle tissues, and intense vascularization by pulsed Doppler and contrast-enhanced ultrasound (CEUS). Guided biopsy was performed to confirm the diagnosis of hemangiosarcoma. The objective of this study was to describe B-mode ultrasound, CEUS, and ARFI findings of hemangiosarcoma in the vastus lateralis musculature of a bitch. Case: A 10-year-old spayed bitch Golden Retriever weighing 36 kg was evaluated for pelvic limb lameness. The patient presented with bilateral pain during hip extension. The primary diagnostic suspicion was degenerative joint disease and secondary hip dysplasia. The patient was referred for imaging evaluation of the hip joints (radiography and ultrasound) under anesthesia. Right lateral and ventrodorsal projections with the pelvic limbs extended were obtained to confirm the diagnosis. In the right pelvic limb, an amorphous hypoechoic structure with irregular contours and heterogeneous echotexture was observed in the vastus lateralis muscle. In ARFI elastography, it was possible to identify differences in tissue stiffness between healthy and compromised portions. Pulsed-wave Doppler evaluation demonstrated an arterial waveform pattern with a peak systolic velocity of 38.8 cm/s, end-diastolic velocity of 6.9 cm/s, pulsatility index of 1.76, and resistive index of 0.82. CEUS study identified a mean peak of 27.26 %, mean time to peak of 39.95 s, and mean transmission time of 49.96 s. The popliteal lymph node was hyperechoic and heterogeneous in B-mode. In ARFI elastography, the average stiffness was 2.52 m/s, and the CEUS obtained an average peak of 19.98%, average time to peak of 17.52 s, and mean transit time of 22.83 s. Doppler assessment revealed no clear vascularization in the lymph node. Thoracic radiography in 3 projections and abdominal ultrasonography were performed. Radiographic evidence of pulmonary nodules was not observed. On abdominal ultrasound evaluation, it was possible to identify changes in the spleen, which presented with splenomegaly, mixed echogenicity, and heterogeneous echotexture. The animal underwent ultrasound-guided muscle biopsy, which confirmed the presence of hemangiosarcoma in the muscle. The bitch was referred for splenectomy and lymphadenectomy of the right popliteal, which confirmed neoplastic involvement of the same neoplasm. Discussion: On B-mode ultrasound, the observed changes were similar to those in a report of hemangiosarcoma in the muscles of the chest wall in dogs, which contributed to the diagnosis. Although it was only one patient, ARFI elastography results suggest that muscle hemangiosarcoma tends to follow the same elastographic characteristics as malignant lesions in other tissues. Additionally, the popliteal lymph node had a stiffness suggestive of malignancy (mean 2.52 m/s) because it presented a similar result and greater elasticity of metastatic axillary lymph nodes in bitches (>2.5 m/s) and women (> 1.44 m/s) with breast tumor. With CEUS, it was possible to identify vascularization in the sentinel lymph node that was not visible by pulsed Doppler, and in muscle mass. The findings of this report provided relevant results on muscle hemangiosarcoma in a bitch and demonstrated that the information obtained with the association of imaging methods supported the malignancy criteria described in other studies.
Assuntos
Animais , Feminino , Cães , Neoplasias Pélvicas/veterinária , Pelve/diagnóstico por imagem , Hemangiossarcoma/diagnóstico por imagem , Ultrassonografia/veterinária , Ultrassonografia Doppler de Pulso/veterinária , Técnicas de Imagem por Elasticidade/veterináriaResumo
Purpose: To evaluate macro/microscopic viability of the upper pole (UP) in rats after 80 days of subtotal splenectomy preserving the upper pole (SSPUP). Methods: Twenty-five male Wistar rats were submitted to SSPUP. After 80 days, the rats were euthanized, and the remaining UP was evaluated macroscopically regarding appearance, color, consistency, length, width, thickness, and presence of fibrosis/necrosis; and microscopically regarding presence of red and white pulp, fibrosis/necrosis. Results: Two rats died during surgery and were removed from the statistical analysis. There was statistically significant increase in length and width between the pre and postoperative in the experimental group, with no significant difference in thickness. In the manipulation group, the macroscopic appearance of the spleen was normal in pre and postoperative, with viability preserved. In the experimental group, two UP of the spleen were not found during the second surgery. Macroscopically, it was observed absence of fibrosis and necrosis in all cases. Microscopically, the white and red pulp were intact in both groups. Two spleens of rats in the manipulation group presented areas with fibrosis and necrosis focus, which were not enough to be considered inviable. Conclusions: The UP of the spleen remained viable in 91.3% of the cases.
Assuntos
Animais , Ratos , Baço , Esplenectomia , Ratos Wistar , Animais de LaboratórioResumo
ABSTRACT Purpose The spleen is relevant in blood purification, hematopoiesis, metabolism, and immune response to antigens, in addition to the storage and control on the release of metals and amino acids. Its functions concerning reproduction characteristics are still unknown. The objective was to study the influence of splenectomies on reproduction. Methods This study analyzed 25 mice couples, distributed into five groups: group 1 - control, no surgery: group 2 - control, submitted to laparotomy and laparorrhaphy only; group 3 - splenectomy in male mice; group 4 - splenectomy in female mice; group 5 - splenectomy in male and female mice. The animals were studied as regards the number of gestations and offspring generated in each gestation. Results A decrease in both the number of gestations and the number of offspring was verified in the male mice that had received a splenectomy when coupled with normal female mice. It is important to emphasize lower reproduction level when paired asplenic males with normal females, otherwise, the couples in which both mice had been splenectomized did not present change in the reproduction pattern. Conclusions A reduction in the number of pregnancies and litters occurs in mice couples when the male mice were previously splenectomized.
Assuntos
Animais , Feminino , Gravidez , Camundongos , Esplenectomia , Procedimentos de Cirurgia Plástica , BaçoResumo
ABSTRACT Purpose To evaluate the influence of autonomic vagal and splenic activities on renal histomorphometric aspects in obese rats. Methods Thirty male Wistar rats were used, of which, 24 received subcutaneous injections of monosodium glutamate (MSG) during the first 5 days of life (4 g/kg body weight) and six control animals received injections of saline solution (CON). Five experimental groups were organized (n = 6/group): falsely-operated control (CON-FO); falsely-operated obese (MSG-FO); vagotomized obese (MSG-VAG); splenectomized obese (MSG-SPL); vagotomized and splenectomized obese (MSG-VAG-SPL). Results The MSG-FO group animals showed a significant reduction in body weight and nasal-anal length when compared to CON-FO group animals (p < 0.05). The MSG-VAG-SPL group showed significant reduced in most biometric parameters associated with obesity. Falsely-operated obese animals showed a significant reduction in renal weight, glomerular diameters, glomerular tuff and capsule areas and Bowman's space compared to CON-FO group animals (p < 0.05). There was a significant reduction in diameter, glomerular tuft and capsule areas, and Bowman's space in MSG-VAG, MSG-SPL, MSG-VAG-SPL groups when compared to the MSG-FO group. Conclusions Vagotomy associated with splenectomy induces a reduction in the adiposity and causes histological changes in the kidney of obese rats.
Assuntos
Animais , Masculino , Ratos , Esplenectomia , Vagotomia , Ratos Wistar , Rim , Lipídeos , ObesidadeResumo
Background: The histiocytic sarcoma (HS) complex is a set of malignant neoplasms originating from interstitial dendritic cells or macrophages. When it involves macrophages of the splenic red pulp and bone marrow, it is referred to as hemophagocytic histiocytic sarcoma (HHS). HHS behaves more aggressively than HS and is usually fatal. HHS can be diagnosed by cytological and histopathological examination of neoplastic tissue. HHS is confirmed by immunohistochemistry using an anti-CD11d antibody. This neoplasm is often confused with immune-mediated hemolytic anemia or Evans syndrome due to erythrophagocytosis and platelet consumption. The clinical presentation of the animals progresses with evident anemia and thrombocytopenia, leading to signs such as prostration, inappetence, and pale mucosa, making diagnosis challenging and often late. This study aimed to report the clinic-pathological aspects of a canine with atypical hemophagocytic splenic HS. Case: A 4-year-old male Shih-Tzu canine was referred to the Veterinary Hospital with a history of prostration and anorexia. Pale mucous membranes were observed on physical examination. Blood tests revealed non-regenerative anemia, leukopenia, and thrombocytopenia. Serum protein levels were below the reference values for the species in biochemical examinations. Hemoparasitosis was suspected; however, the result of the polymerase chain reaction was negative. Abdominal ultrasound revealed a splenomegaly with heterogeneous parenchyma and a slightly irregular surface, but no visible mass in the spleen. Due to the difficulty of stabilizing the patient, even after successive transfusions, the animal underwent exploratory laparotomy with medial access and posterior splenectomy. Subsequently, the spleen was surgically removed, fixed in 10% buffered formalin, and processed routinely. Macroscopically, it had an irregular reddish-brown capsular surface. Histopathological examination of the spleen revealed a densely cellular neoplasm composed of round to spindle cells (histiocytes) arranged haphazardly in variably sized sheets separating the pre-existing spleen stroma. These histopathological findings were consistent with a histiocytic malignant neoplasm. Immunohistochemical analysis was performed to better define the origin of the histiocytic neoplasm. Neoplastic cells showed positive immunostaining of more than 80% of tumor cells for the CD11d antibody and weak immunostaining for CD11c and lysozyme. The patient survived for less than 30 days after the first hospital visit. Discussion: The diagnosis of HHS was based on the histological characteristics and positive immunostaining of more than 80% of the tumor cells for the CD11d antibody. HHS is an extremely aggressive and rare tumor that affects elderly dogs of any breed. In this study, HHS had atypical histologic characteristics, in which erythrophagocytosis and hemosiderin were not observed within macrophages. HHSs arise from macrophages of the red pulp of the spleen or bone marrow and express the b2 integrin, CD11d, and have low expression of CD1 and CD11c, which are predominantly expressed by non-hemophagocytic HS. The hematological and biochemical changes observed in this case were similar to those described in other dogs with HHS. Treatment of HHS is only palliative. Erlichia ewingii, E. canis, Anaplasma phagocytophilum, A. platys, Borrelia burgdorferi, Dirofilaria immitis, Leishmania infantum and immune-mediated hemolytic anemia are the main differential diagnoses because they cause anemia and thrombocytopenia accompanied by splenomegaly.
Assuntos
Animais , Masculino , Cães , Esplenopatias/veterinária , Células Dendríticas/patologia , Sarcoma Histiocítico/veterinária , Esplenectomia/veterinária , Imuno-Histoquímica/veterinária , Ultrassonografia/veterináriaResumo
Background: Splenic stromal neoplasms are a heterogeneous group of tumors that shares the morphology of spindle cells, and are considered a primary mesenchymal neoplasm of the spleen. Among these neoplasms, some are as yet unclassified. Although stromal neoplasms represent 25 a 50% of dog splenic neoplasms in dogs, subtypes rarely occur alone. As these neoplasms are difficult to diagnose in the routine veterinary medical examination, the objective of this article was to report a case of splenic stromal sarcoma in a dog treated at a private veterinary hospital in Recife, Pernambuco, Brazil. Case: An 8-year-old male labrador dog was treated at a veterinary hospital for an initial clinical suspicion of gastroenteritis. Clinical examinations showed anemic ocular mucosa and a distended abdomen. Considering the animal's condition, blood count, serum biochemistry, and abdominal ultrasonography (US) were requested. The laboratory tests revealed anemia, thrombocytopenia, leukocytosis with neutrophilia, and changes in the indices of alanine aminotransferase (ALT) and alkaline phosphatase (ALP), among other findings. Abdominal ultrasound showed hepatomegaly, diffuse splenomegaly, a neoformation in the spleen suggestive of splenic neoplasia, and mild cystic prostatic hyperplasia. The dog underwent exploratory laparotomy with splenectomy. During the procedure, a nodule was found attached to the spleen. It was removed, fixed in a 10% neutral buffered formalin solution, and sent for histopathological and immunohistochemical examinations (vimentin, S100, desmin, MyoD1, HHF35, CD31, and alpha smooth muscle actin). The histopathological diagnosis was poorly differentiated spindle cell splenic sarcoma, compatible with splenic stromal sarcoma. Immunohistochemistry showed neoplastic cells immunoreactive for vimentin and S100, and it was not reactive for other markers. Based on the immunohistochemical and morphological profile, the diagnosis of splenic stromal sarcoma was confirmed. Discussion: Dogs affected by splenic neoplasms are generally aged between three and 17 years, and clinically present with anorexia, emesis, lethargy, weight loss, and abdomen distension, which were observed in the present case. However, a purelyclinical diagnosis is disputable, since other diseases can present the same signs. Thus, complementary exams are essential for a correct diagnosis. Laboratory changes in blood count and serum biochemistry are considered nonspecific for splenic neoplasms, with neutrophilic leukocytosis and anemia being consistent with paraneoplastic syndromes frequently diagnosed in small animals. Microscopically, splenic stromal sarcomas are characterized by focal splenic nodules composed of cohesive polygonal to spindle-shaped cell layers. The cells usually exhibit anisokaryosis and often have large oval to round vesicular nuclei and, occasionally, multinucleated cells. They have large areas of necrosis, diffuse or nodular lymphoid aggregates, and foci of extramedullary hematopoiesis, consistent with the histopathological examination reported in the present case. The immunohistochemical analysis included evaluation of seven markers to elucidate the histogenesis of the neoplasm, with the anti-vimentin and anti-S100 markers demonstrating positive cytoplasmic immunoreactivity, revealing the mesenchymal origin of the neoplasm. Thus, the definitive diagnosis was splenic stromal sarcoma, a rare and aggressive neoplasm.
Assuntos
Animais , Masculino , Cães , Sarcoma/veterinária , Esplenopatias/veterinária , Neoplasias Esplênicas/veterinária , Imuno-Histoquímica/veterinária , Laparotomia/veterináriaResumo
Abstract Purpose: Comparing survival rates of rats subjected to spleen procedures after fecal peritonitis induction. Assessing changes in TCD4 and CD8 lymphocyte rates before and after the procedures. Correlating animal survival with CD4 and CD8 lymphocytes. Methods: Thirty male Wistar rats were distributed into 3 groups of ten: spleen manipulation (SM); total splenectomy (TS); subtotal splenectomy with preservation of the inferior pole (IP). Rats were subjected to surgical procedure depending on the group. Seven days after surgery they underwent induction of peritonitis and survival time was recorded. All animals were subjected to two blood collections: before surgery and 70 days after it for TCD4/TCD8 lymphocyte counting. Results: Mean survival time was longer in the IP and SM groups and shorter in the TS group; there was significant difference between them. The comparison of the median number of CD4 did not present changes, whereas the comparison of the median number of CD8 decreased in the SM and IP groups. The correlation between the median number of TCD4 and TCD8 lymphocytes and the animals' survival was not significant. Conclusion: The maintenance of splenic tissue contributed to increase the survival of rats and there was a change in the number of TCD8 lymphocytes.
Assuntos
Animais , Masculino , Ratos , Peritonite , Baço , Esplenectomia , Linfócitos , Ratos WistarResumo
Abstract Purpose To evaluate the viability of the upper (UP) and lower pole (LP) of the spleen from a macro and microscopic point of view, after subtotal splenectomy with preservation (SSP) of the UP and the LP. Methods Seventeen male Wistar rats, two months old, were submitted to SSPUP and SSPLP and 5 to simulated operation (SG). After 80 days, the rats were euthanized, and the remaining LP and UP and intact spleens were evaluated macroscopically and microscopically. Results Two rats died during the operation. Macroscopic analysis showed that in 15 LP, one of them was not viable and in 15 UP and in 5 spleens in the SG, all were viable. In the statistical analysis, there was no difference in relation to viability. The LP and UP analyzed showed variation. As for the length, the UP increased significantly; however, in relation to the width, there was a significant increase in the LP in relation to the UP. In addition, the weight of the UP was significantly greater than that of the LP. Microscopic analysis attested viability of the splenic remnants. Conclusion There was no significant difference regarding the viability of UP and LP, in macroscopy and microscopy.
Assuntos
Humanos , Animais , Masculino , Lactente , Ratos , Baço/cirurgia , Esplenectomia , Período Pós-Operatório , Ratos WistarResumo
Background: Hernias are changes with the displacement of organs from their normal anatomical location to a newly formedcavity, which can cause pain and dysfunction of the affected organ. The diagnosis can be obtained by palpation or by ultrasound.The treatment of choice is surgical and vision to promote the return of the organ to its normal anatomical position and theclosure of the hernial ring. When affixing the edges of the hernial ring is not possible, alternative techniques such as the useof biological or synthetic membranes should be sought. The aim of the present study is to report an atypical case of inguinalhernia with splenic incarceration, in which splenectomy and herniorrhaphy with a bovine phrenic center were performed.Case: An 8-year-old large mestizo male dog was referred to the Veterinary Hospital of Uberaba complaining of the appearance of a mass in the inguinal region that increased significantly in the last 15 days. On physical examination, there was anincrease in volume in the left inguinal region, irreducible and great pain sensitivity in the region. The hemogram showednormochromic normocytic anemia, hyperproteinemia and thrombocytopenia. No changes were observed in the biochemicalanalyzes. Urinalysis revealed the presence of protein and traces of occult blood. Ultrasound showed an enlarged spleen insidethe hernial sac, closing the diagnosis of inguinal hernia. The animal underwent a herniorrhaphy procedure associated with theuse of a biological membrane from a bovine phrenic center and splenectomy. In addition, contralateral inguinal hernia wasobserved. The animal remained hospitalized and under observation for three days. On return, after five days, the guardian..
Assuntos
Masculino , Animais , Cães , Baço/cirurgia , Baço/diagnóstico por imagem , Hérnia Inguinal/cirurgia , Hérnia Inguinal/veterinária , Xenoenxertos , Abdome/cirurgia , Ultrassonografia/veterináriaResumo
When detecting a proliferative splenic lesion, veterinarians usually choose splenectomy before a conclusive diagnosis, which can provide a deleterious effect to the dog. The most appropriate would be to perform splenectomy as a therapeutic procedure only in cases with real surgical indication, which can be established after defining microscopic diagnosis and prognosis. The objectives of this study were: to determine the frequency of different types of lesions in spleens of splenectomized dogs in the period of 12 years (2006-2017); determine the representativity of neoplastic lesions (benign and malignant) and non-neoplastic lesions; to evaluate and compare the safety and efficiency of fine needle aspiration biopsy (FNA) and ultrasound-guided Tru-cut needle biopsy for cytological and histopathological diagnosis, respectively, of splenic nodular lesions. In the studied period 224 cases of lesions were found in splenectomized spleens. The frequency of non-neoplastic lesions (50,45%, 113/224) and neoplastic lesions (49,55%, 111/224) was very similar. Among the neoplastic lesions, the malignant ones were more frequent (79,27%, 88/111), and the hemangiosarcoma was the most common (52,25%, 58/111). The possibility of malignant neoplasm was about 74% greater than a benign one. In summary, it was verified that 60.71% (136/224) of the cases corresponded to benign lesions without indication to splenectomy. FNA techniques and Tru-cut biopsy showed a low risk of complications. Regarding the diagnostic efficacy, the FNA obtained 71.43% (15/21) of conclusive diagnoses, 60% (9/15) of which were compatible with the final result of the histopathological evaluation, after splenectomy (gold standard). The Tru-cut biopsy obtained 71.43% (5/7) of conclusive diagnoses and 28.57% (2/7) of inconclusive diagnoses. Among the conclusive one, in 100% of the cases the diagnosis was compatible with the gold standard. Thus, since the possibility of benign splenic lesions in dogs is 1.52 times greater than malignancies, splenectomy should be recommended as a therapeutic procedure only in cases with proven surgical indication, which can be established after definition of microscopic diagnosis and prognosis. The use of FNA and Tru-cut biopsy should be recommended, especially for small and focal splenic lesions, since such techniques are good alternatives for establishing diagnosis previously to splenectomy, which may reduce the number of unnecessary splenectomies. The importance of recommending such techniques is emphasized, especially for dogs with focal splenic lesions smaller than three centimeters.(AU)
Rotineiramente, frente à detecção de uma lesão proliferativa esplênica, médicos veterinários costumam optar pela esplenectomia antes de se obter o diagnóstico definitivo da lesão esplênica, o que pode trazer consequências deletérias ao cão. O mais apropriado seria, contudo, a sua adoção, como medida terapêutica, apenas nos casos com comprovada indicação cirúrgica, o que pode ser estabelecido após o diagnóstico microscópico e prognóstico definidos. Os objetivos desse estudo foram: determinar a frequência dos diferentes tipos de lesão em baços de cães esplenectomizados no período de 12 anos (2006-2017); determinar a representatividade das lesões neoplásicas (benignas e malignas) e não neoplásicas; avaliar e comparar a segurança e a eficiência da punção aspirativa por agulha fina (PAAF) e da biópsia por agulha Tru-cut guiadas por ultrassom para o diagnóstico citológico e histopatológico, respectivamente, de lesões nodulares esplênicas. No período estudado foram encontrados 224 casos de lesões em baços esplenectomizados. A frequência de lesões não neoplásicas (50,45%, 113/224) e neoplásicas (49,55%, 111/224) esplênicas foi muito semelhante. Entre as neoplásicas, as de caráter maligno foram mais frequentes (79,27%, 88/111) e o hemangiossarcoma o mais comum (52,25%, 58/111). A possibilidade de ocorrência de uma neoplasia maligna foi cerca de 74% maior do que uma benigna. Em suma, verificou-se que em 60,71% (136/224) dos casos estudados, tratava-se de lesões benignas que não teriam indicação de esplenectomia. As técnicas de PAAF e a biópsia por agulha Tru-cut demonstraram ter baixo risco de complicações. Quanto à eficácia diagnóstica, pela PAAF obteve-se 71,43% (15/21) de diagnósticos conclusivos, sendo 60% (9/15) desses compatíveis com o resultado final realizado pela avaliação histopatológica, após a esplenectomia (padrão ouro). Já a biópsia por Tru-cut obteve 71,43% (5/7) de diagnósticos conclusivos e 28,57% (2/7) de inconclusivos. Dentre os conclusivos, em 100% dos casos o diagnóstico foi compatível com o padrão ouro. Desta maneira, visto a possibilidade de ocorrência de lesões esplênicas benignas em cães serem 1,52 vezes maior do que as malignas deve ser recomentado a adoção de esplenectomia, como medida terapêutica, apenas nos casos com comprovada indicação cirúrgica, o que pode ser estabelecido após o diagnóstico microscópico e prognóstico definidos. O uso da PAAF e da biópsia por Tru-cut deve ser recomentado, sobretudo, para lesões esplênicas pequenas e focais, uma vez que tais técnicas representam boas alternativas para o estabelecimento do diagnóstico prévio a esplenectomia, o que pode reduzir o número de esplenectomias desnecessárias. Enfatiza-se a importância da recomendação de tais técnicas, sobretudo para cães com lesões esplênicas focais menores do que três centímetros.(AU)
Assuntos
Animais , Cães , Baço/cirurgia , Esplenectomia/veterinária , Neoplasias Esplênicas/veterinária , Biópsia por Agulha Fina/veterináriaResumo
Background: Primary splenic torsion occurs when there is a splenic vascular pedicle rotation without association of otherdiseases, as the Gastric Dilatation Volvulus (GDV). Accessory spleen consists in a splenic tissue fraction independentfrom main organ, caused by a spleen defect in the embryonic development, most remaining asymptomatic and discoveredincidentally. They have their own blood supply, which is usually from a branch of the splenic artery. Present report represents a primary splenic torsion with the accessory spleen finding in a dog.Case: A 7-year-old female mongrel was referred to Veterinary Hospital of Universidade Federal do Rio Grande do Sul,showing pain and firm consistency in the left abdominal region, prostration and inappetence four days before the medicalappointment. At the clinical examination, the patient was alert, 7% dehydration, hypocorous mucous membranes, withoutalteration in lymph nodes, left abdominal pain. Laboratory tests, chest radiographic and abdominal ultrasound was requested.Two images compatible with splenic image were visualized, one with a regular structure without vascularization suggestingsplenic torsion and another with homogeneous parenchyma and echogenicity of the normal spleen, with vascularizationsignal. The animal was referred to the surgical procedure and the anesthetic induction protocol with propofol (6 mg/kg-1)and ketamine hydrochloride (2 mg/kg-1) and maintenance with total intravenous anesthesia with propofol (0.2-0.4 mg/kg-1/min) and lidocaine (2 mg/kg-1), in a semi-closed loop and spontaneous ventilation. The pre-retro-umbilical incision in theventral midline was performed, and the exploratory celiotomy was done. During the cavity exploring, a small amount of freefluid and a structure compatible with the spleen were observed. It was noted that the splenic vascular pedicle was twistedaround its axis and the gastroesplenic and splenocolic ligaments were also involved...
Assuntos
Animais , Cães , Anormalidade Torcional/veterinária , Baço/anormalidades , Baço/patologia , Esplenectomia/veterináriaResumo
The study aimed to evaluate and compare the clinical, laboratory and pathological aspects of buffalo and bovine experimentally infected with AmRio 2 strain of Anaplasma marginale. Four Murrah buffaloes and four crossbred cattle were used in the experiment, which two animals of each species were splenectomized. Strain AmRio 2 of A. marginale was inoculated in all experimental animals. Clinical exams, Packed Cell Volume (PCV), blood counts, blood smears, rickettsemia, necropsy and histopathology were performed in all cases. Semi-Nested-PCR (snPCR) for the msp5 and snPCR for the msp1α target gene for identification of A. marginale in blood samples from animals was done. From positive samples for msp1α snPCR, samples were analyzed for the amino acid sequences of this gene. Two splenectomized cattle presented apathy, pale mucous membranes, jaundice, hyperthermia, and severe anemia. The remaining experimental animals did not show clinical signs. The rickettsemia in all animals was less than 1%. The mean PCV of the splenectomized cattle was below 20% at two-time points after infection. On the blood count, the main changes were observed in splenectomized calves and were characterized by a decrease in red blood cells, hemoglobin, PCV and platelets (p <0.05). All animals presented leukocyte elevation by increased lymphocytes, however, with no significant difference. The average prepatent period was two days in all the animals. The average incubation period in cattle that became ill was 25.5 days, and death occurred, on average, 63 days after inoculation of the strain. The necropsy findings were characterized by pale carcass, ascites, enlarged liver, distended gallbladder, and thick bile. Histopathological findings included infiltration of macrophages and lymphocytes in various organs, hepatic sinusoidal dilatation, and necrosis of the large intestine. In snPCR for the msp5 gene, 100% of the animals were positive in at least one evaluation. And in the snPCR for the infection of the msp1α target gene was also found in all animals in at least one sample evaluated. However, sequencing revealed only five animals, including the bovine which died, with a similarity of the amino acid sequences with AmRio 2 strain of A. marginale. It is concluded that the splenectomized cattle died due to anaplasmosis caused by the inoculated strain and the buffalo were more resistant compared to cattle. Buffaloes can be an alternative to cattle rearing in areas with a high occurrence of clinical cases of anaplasmosis.(AU)
O estudo teve como objetivo avaliar e comparar os aspectos clínicos, laboratoriais e patológicos de búfalos e bovinos infectados experimentalmente com estirpe AmRio 2 de Anaplasma marginale. Para isso, foram utilizados quatro bubalinos Murrah e quatro bovinos mestiços, sendo dois animais de cada espécie, esplenectomizados. Estirpe AmRio 2 de A. marginale foi inoculada em todos os animais. Foram realizados exames clínicos, hematócrito, hemograma, esfregaço sanguíneo com avaliação de riquetsemia, necropsia e histopatologia, além de, Semi-Nested-PCR (snPCR) para o gene alvo msp5 e snPCR para o gene alvo msp1α para identificação de A. marginale nas amostras de sangue dos ruminantes. A partir das amostras positivas na snPCR msp1α, foram selecionadas amostras para análise das sequências de aminoácidos deste gene. Dois bovinos esplenectomizados apresentaram apatia, mucosas pálidas, icterícia, hipertermia e anemia severa. O restante dos animais não apresentou sintomatologia clínica. A riquetsemia em todos os animais foi menor que 1%. A média do hematócrito dos bovinos esplenectomizados esteve abaixo de 20% em dois momentos após infecção. Ao hemograma, as principais alterações observadas foram nos bovinos esplenectomizados e caracterizaram-se por redução de hemácias, hemoglobina, hematócrito e plaquetas (p<0,05). Todos os animais apresentaram elevação de leucócitos por aumento de linfócitos, porém, sem diferença significativa. O período pré-patente médio foi de dois dias em todos os animais. O período de incubação médio nos bovinos que adoeceram foi de 25,5 dias e estes morreram em média 63 dias após inoculação da estirpe. Os achados de necropsia caracterizaram-se por carcaça pálida, ascite, aumento de volume do fígado, vesícula biliar distendida e bile espessa. À histopatologia, verificou-se infiltração de macrófagos e linfócitos em diversos órgãos, dilatação dos sinusoides hepáticos e necrose do intestino grosso. A snPCR para o gene msp5, revelou 100% dos animais positivos em pelo menos um momento de avaliação. E na snPCR para o gene alvo msp1α também verificou-se infecção em todos os animais em pelo menos uma amostra avaliada. Entretanto, o sequenciamento revelou apenas cinco animais, incluindo os bovinos que morreram, com similaridade das sequências de aminoácidos com estirpe AmRio 2 de A. marginale. Conclui-se que os bovinos esplenectomizados morreram em virtude de anaplasmose provocada pela estirpe inoculada e os bubalinos foram mais resistentes em comparação aos bovinos. Finalmente, os búfalos podem ser uma alternativa à criação de bovinos em áreas com alta ocorrência de casos clínicos de anaplasmose.(AU)
Assuntos
Animais , Bovinos , Anaplasma marginale/isolamento & purificação , Anaplasmose/patologia , Esplenectomia/veterinária , Reação em Cadeia da Polimerase/veterináriaResumo
Abstract Purpose: To evaluate a novel and adapted low-cost set model for laparoscopic surgery in rats. Methods: Nine Wistar rats underwent two different laparoscopic procedures, splenectomy (n=3) and distal pancreatectomy with splenectomy (n = 6), after assembling a low-cost set replacing the conventional one (monitor, micro camera, image processor, light source, laparoscope and insufflator). The new set included an Android Tablet 10.5 ", a 5mm USB Endoscope and semiautomatic sphygmomanometer monitor. Results: The same surgeon performed the laparoscopic procedures. Total surgical time ranged from 36 to 60 minutes with a mean of 45.8 minutes. Three rats died during the distal pancreatic and splenectomy procedure (33.3%), due to respiratory failure (n = 1), uncontrolled abdominal hemorrhage (n=1) and iatrogenic gastric perforation (n = 1). We followed the other six rats (66.6%) for seven days with no further evidence of complications. Conclusions: The laparoscopic partial pancreatectomy and splenectomy can be performed with the novel low-cost set assembled in the present experimental study. Both specific training and skills development are required to validate more advanced laparoscopic procedures and achieve a desirable outcome.
Assuntos
Animais , Ratos , Pancreatectomia/educação , Esplenectomia/educação , Laparoscopia/educação , Pancreatectomia/economia , Pancreatectomia/métodos , Esplenectomia/economia , Esplenectomia/métodos , Ratos Wistar , Laparoscopia/economia , Laparoscopia/métodos , Custos e Análise de Custo , Modelos AnimaisResumo
Background: Myelolipomas are benign tumors composed of a mixture of fat and hematopoietic tissue similar to the bone marrow. They are rare tumors in humans and dogs, and occur generally in the spleen, liver, spinal canal and in the adrenal glands. When they develop in the adrenal glands they feature non-secretory and endocrinologically inactive characteristics, usually without clinical signs or other dysfunctions. Thus, they are often an incidental finding during necropsy. This paper aims to describe a case of functional adrenal gland myelolipoma and spleen myelolipoma in a female dog with clinical signs and laboratory tests compatible with hyperadrenocorticism.Case: A 12 year-old female dog, undefined breed, was treated at the Hospital Unit for Companion Animals of the Pontifical Catholic University of Paraná (PUCPR), São José dos Pinhais, Paraná, Brazil, with polyuria, polydipsia, polyphagia, cutaneous hypotonia and central obesity. Blood tests showed hypercholesterolemia and increased alkaline phosphatase; urinalysis identified isostenuria with proteinuria; and ultrasound and MRI of the abdomen indicated right adrenomegaly, with heterogeneous characteristics, without invasion of attached blood vessels and splenic nodules. The low dose dexamethasone suppression test was performed which confirmed hyperadrenocorticism. The animal was submitted to adrenalectomy and splenectomy, and tissue specimens were obtained for histopathological examination, which revealed mature adipocytes and hematopoietic elements in different phases of maturation, compatible with adrenal and spleen myelolipoma. After surgical treatment, there was a progressive improvement of the clinical manifestations and laboratory abnormalities of hypercortisolemia, without recurrence during one year.[...]
Assuntos
Feminino , Animais , Cães , Hiperfunção Adrenocortical/cirurgia , Hiperfunção Adrenocortical/diagnóstico por imagem , Hiperfunção Adrenocortical/veterinária , Mielolipoma/complicações , Mielolipoma/diagnóstico , Mielolipoma/veterináriaResumo
Background: A primary splenic torsion occurs when the organ rotates around its vascular pedicle in the absence of any other concomitant disease. The occurrence of primary splenic torsion is rare, with a prevalence lower than 1%. Splenic torsion is more often related to dilated gastric volvulus syndrome, and it has no clear etiology despite reports that associate it with congenital abnormalities or traumatic ruptures of the gastrosplenic or splenocolic ligaments. This study reports a case of splenic torsion in an American Pit Bull terrier dog, its related symptomatology, and the treatment adopted.Case: A 3-year-old male American Pit Bull terrier dog weighing 32 kg was admitted to the hospital with symptoms of acute abdomen, lethargy, increased abdominal volume, discomfort, restlessness, and with a history of collapse three days prior to admission. Clinical examination revealed lethargy, pale mucous membranes, reduced capillary refill time, moderate dehydration, and hyperthermia. Abdominal palpation revealed increased abdominal volume in the epigastric and mesogastric areas. CBC and serum biochemistry profile revealed hypochromic normocytic anemia, leukocytosis with absolute neutrophilia and eosinopenia, mild hypoalbuminemia, and thrombocytopenia. PCR for detection of Babesia sp. and Ehrlichia sp., which returned negative results, and measurement of clotting time, which was prolonged, were performed to exclude immune-mediated hemolytic anemia. Radiographic and ultrasonographic images showed a normal stomach, but revealed presence of splenomegaly. An exploratory laparotomy allowed direct observation of the spleen, which exhibited an increased volume, a blackened, cold, hyperemic appearance, and a complete torsion of the splenic vascular pedicle; the surgical team opted to perform total splenectomy rather than undoing the pedicle twist. The animal returned to the hospital after 10 days exhibiting an excellent clinical condition.[...]
Assuntos
Masculino , Animais , Cães , Anormalidade Torcional/diagnóstico por imagem , Anormalidade Torcional/veterinária , Esplenopatias/cirurgia , Esplenopatias/terapia , Esplenopatias/veterinária , Abdome Agudo/diagnóstico , Abdome Agudo/etiologia , Abdome Agudo/veterináriaResumo
Background: Splenic hematoma is an encapsulated blood accumulation, which is macroscopically indistinguishable from malignant spleen. The treatment of choice and final diagnosis were by splenectomy and exploratory laparotomy followed by biopsy and histopathological examination, respectively. Nylon tie bands are devices made of polyamide 6.6, same material of surgical nylon wires, and has been used in different surgical procedures in animals. The present report case aimed to describe the use of nylon tie bands polyamide 6.6 in a 2.3-year-old Golden retriever dog diagnosed with splenic hematoma and lymphoid hyperplasia; and the clinical presentation, diagnostic evaluation, histological diagnosis of splenic hematoma and lymphoid hyperplasia. Case: A 2.3-year-old intact male Golden retriever dog was presented with history of anorexia, apathy, regurgitation and weight loss. During the physical examination was identified a mass in the left side of abdomen. The complete blood count (CBC), serum biochemistry, urinalysis, and thoracic radiographs were no alteration. Abdominal ultrasound revealed splenomegaly and heterogeneous hypoechoic structure. Splenectomy using an adjustable nylon ties polyamide 6.6 for hemostasis technique was performed during an exploratory laparotomy. The spleen presented hematoma and lymphoid hyperplasia at the histopathological examination, as well as the presence of siderocalcinotic plate in the trabecular spleen. The dog presented with no regurgitation, apathy or anorexia after 10 days of surgery. CBC, serum biochemistry analysis, thoracic radiographs and abdominal ultrasound revealed no abnormalities. Video laparoscopy did not showed any sign of adherence on the local where used the nylon tie bands. One year and three months after the surgery, the owner was contacted by telephone, since he had changed to other city, and he reported that the dog was healthy without any clinical signs...
Assuntos
Masculino , Animais , Cães , Esplenopatias/veterinária , Estruturas Linfoides Terciárias , Hemostasia Cirúrgica/métodos , Hemostasia Cirúrgica/veterinária , Nylons , Esplenectomia/veterináriaResumo
Abstract Purpose: To investigate the impacts of albumin synergized with hydroxyethyl starch (HES) on early microvascular albumin leakage after major abdominal surgery in rabbits. Methods: Forty male Japanese rabbits were randomly divided into four groups: the control group, the saline group, the albumin group, and the Syn group (hydroxyethyl starch+albumin). The latter three groups were performed gastrectomy plus resection of pancreatic body and tail and splenectomy. The serum albumin concentration was detected before and 48h after surgery, and the conditions of mesenteric microvascular leakage in these 4 groups were observed under microscope 48 h after surgery to calculate the leakage rate. Results: Compared with the saline group, the albumin group and the Syn group exhibited significantly increased serum albumin concentrations 48h after surgery (P<0.05). The albumin leakage rate was the most obvious in the albumin group, followed by the saline group, while that in the Syn group was the minimal, and there existed significant differences among these groups (P<0.05) . Conclusion: Simple administration of albumin in the early stage after major abdominal surgery could increase the albumin leakage, while the synergization of albumin and hydroxyethyl starch could reduce the albumin leakage.
Assuntos
Animais , Masculino , Coelhos , Albumina Sérica/administração & dosagem , Albumina Sérica/análise , Permeabilidade Capilar/fisiologia , Derivados de Hidroxietil Amido/administração & dosagem , Albumina Sérica/metabolismo , Cloreto de Sódio , Distribuição Aleatória , Deslocamentos de Líquidos Corporais/fisiologia , Modelos Animais , Sinergismo Farmacológico , Abdome/cirurgiaResumo
The spleen of dogs is frequently affected by disorders that vary from local and systemic origin. The difficulty in associating clinical and gross findings contributes for the choice of total splenectomy as the main treatment, leading to an impairment of the immune and hematopoietic functions. The aim of this study was to evaluate the pathological findings in the spleen of splenectomized dogs during 2008 to 2014 at a Veterinary Teaching Hospital. From the 71 cases analyzed, 97% (69/71) of the dogs were submitted to total splenectomy and 3% (2/71) to partial splenectomy. In 45 (63.4%) of these cases, the histopathological diagnosis was non-neoplastic alterations; only 36.6% (26/71) had a splenic neoplasia. The main non-neoplastic lesions observed were nodular hyperplasia 24.4% (11/45), infarction 22.3% (10/45), and hematoma 20% (9/45). The most frequent tumors were hemangiosarcoma 50% (13/26), histiocytic sarcoma 23% (6/26), and lymphoma 11.5% (3/26). The clinical methods used to diagnose splenic lesions were ultrasonography 88% (63/71), radiography 2.8% (2/71) and exploratory laparotomy 4.2% (3/71). In 4.2% (3/71) the spleen changes were observed during the therapeutic ovariohysterectomy. The results of the present study showed a prevalence of benign disorders in the spleen of splenectomized dogs associated with a high incidence of total splenectomy performed, indicating a difficulty in recognizing the different lesions that can affect the spleen by theveterinarian medical.
O baço de cães é frequentemente afetado por alterações locais ou de origem sistêmica. A dificuldade em associar achados clínicos e macroscópicos contribuem para a escolha da esplenectomia total com principal tratamento, levando a um comprometimento das funções imune e hematopoiética. O principal objetivo deste estudo foi avaliar os achados patológicos no baço de cães esplenectomizados durante 2008 a 2014 em um Hospital Escola Veterinário. Dos 71 casos analisados, 97% (69/71) dos cães foram submetidos à esplenectomia total e 3% (2/71) à esplenectomia parcial. Em 45 (63.4%) casos, o diagnóstico histopatológico foi de alterações não-neoplásicas; somente 36,6% (26/71) tinham neoplasia esplênica. As principais alterações não-neoplásicas observadas foram hiperplasia nodular 24,4% (11/45), infarto 22,3% (10/45) e hematoma 20% (9/45). Os tumores mais frequentes foram hemangiossarcoma 50% (13/26), sarcoma histiocítico 23% (6/26) e linfoma esplênico 11.5% (3/26). Os métodos clínicos utilizados para diagnóstico foram ultrassonografia 88% (63/71), radiografia 2.8% (2/71) e laparatomia exploratória. Em 4,2% (3/71), as alterações esplênicas foram observadas durante ovariohisterectomia terapêutica. Os resultados do presente estudo evidenciam uma prevalência de alterações benignas no baço de cães esplenectomizados, associada com uma alta incidência de esplenectomias totais realizadas, indicam uma dificuldade dos médicos veterinários em reconhecer asdiferentes lesões que podem acometer o baço.