Common bile duct obstruction associated with platinosoma concinum in cat

Extrahepatic obstruction in cat,can be caused by cholelithiasis, inspissated bile, pancreatic inflammation or fibrosis, duodenal inflammation, bile duct carcinoma or liver fluke infection (Amphimerus pseudofelineus e Platynosomurn concinum). A three-year-old, female neutered siames cat was present with a two-month history of progressive letargy, anorexia and emaciation. She had severe icterus of the mucous membranes, skin, and sclerae. A diagnosis of extrahepataic biliary obstruction was made based on the increased levels of conjugated bilirubin in the serum and the ultrasonography. Hepatic fluke eggs were not diagnosed in the feces because the fibrotic bile ducts were occluded and no eggs were shed into the intestine. Cholecystoduodenostomy was done to relieve posthepatic-biliary obstruction.

Proposal of a new technique for bile duct reconstruction after iatrogenic injury. Study in dogs and review of the literature

Purpose: Interposition of a jejunal tube between the common bile duct and duodenum. Methods: Five adult mongrel dogs of both sexes, weighing on average 22.3 kg (18 to 26.5 kg), were used. Obstructive jaundice was induced by ligation of the distal common bile duct. After one week, a 2.5-cm long jejunal tube was fabricated from a segment of the loop removed 15 cm from the Treitz angle and interposed between the common bile duct and duodenum. Results: The animals presented good clinical evolution and no complications were observed. After 6 weeks, complete integration was noted between the bile duct mucosa, tube and duodenum and a significant reduction in total bilirubin and alkaline phosphatase was observed when compared to the values obtained one week after ligation of the common bile duct. Conclusion: The jejunal tube interposed between the dilated bile duct and duodenum showed good anatomic integration and reduced total bilirubin and alkaline phosphatase levels in the animals studied.

Management of congenital nasolacrimal duct obstruction - Latin American study

PURPOSE

Cryptosporidiosis of the biliary tract mimicking pancreatic cancer in an AIDS patient

Diarrhea caused by Cryptosporidium sp is frequent in patients with AIDS, but involvement of other organs of the digestive tract is uncommon. We report a case of Cryptosporidium-associated obstruction of the biliary tract mimicking cancer of the head of the pancreas in a 43-year-old woman with AIDS.

Cinedacryocystography in the diagnosis of lacrimal obstruction in children

Purpose: To analyze the cinedacryocystography in children with congenital nasolacrimal obstruction suspicion. Methods: The cinedacryocystographic examination was done in 143 children (58% of girls and 42% of boys) younger than 5 years old, suspected of congenital nasolacrimal obstruction. The exams were done under general anesthesia and the children were probed immediately when obstruction was detected. Results: Epiphora, discharge or both were the most common complaints. Nevertheless 11% children had undergone unsuccessfully probing once, no one had any radiologic evaluation previously. The cinedacryocystographic exam showed nasolacrimal duct obstruction in 65,73%. Permeable lacrimal vies were presented in 34,3% of the children with epiphora. The obstruction was mainly at the Arlt's sinus. Using the cinedacryocystography, it was possible to observe the lacrimal sac enlargement and alterations in the contiguous structures such as hypertrophic turbinates (91,1%), sinusitis (44,6%) and septum deviation (24,1%). Conclusion: Cinedacryocystographic evaluation provides important information about lacrimal system obstruction in children, therefore, it is useful in all children with suspected congenital lacrimal obstruction.

Spontaneous resolution in congenital nasolacrimal obstruction after 12 months

A retrospective observational study was performed in order to evaluate the possibility of spontaneous resolution of tearing in the congenital nasolacrimal obstruction (CNLO). Twenty-seven CNLO child carriers with spontaneous tearing resolution were evaluated according to sex, age of starting and end of symptoms. The data were evaluated by the Chi-Square Test and non-parametric Mann-Whitney test (p ≤ 0.05). Spontaneous resolution occurred between ages 3 and 48 months (Median = 14 months; Mean = 16.2 ± 10.5 months). The period in which the child presented tearing varied from 2 months to 47.5 months (Median = 12 months) and was similar for both sexes, with or without realization of massage. Our data support the possibility of CNLO spontaneous resolution in children beyond 12 months of age, allowing us to suggest postponed probing beyond this time period. Copyright © Informa Healthcare.

Efeitos da administração de vitamina A hidrossolúvel sobre as lesões e a disfunção hepática na colestase obstrutiva: estudo experimental em ratos jovens

Pós-graduação em Fisiopatologia em Clínica Médica - FMB

Abdominal hyperalgesia in secretory phospholipase A(2)-induced rat pancreatitis: Distinct roles of NK1 receptors

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Biliary tract reconstruction using jejunal tube: an experimental study in dogs

BACKGROUND: To physiologically reconstruct the biliary tract, Crema et al suggested the application of the Monti principle to the biliary tract, already used in humans for the urinary tract. With this technique, a jejunal segment is transversely retubularized. This study aimed to evaluate the efficacy of jejunal tube interposition between the common bile duct and duodenum in dogs.METHODS: Thirteen dogs underwent a laparoscopic common bile duct ligature, followed by a biliodigestive connection by jejunal tube interposition after one week. The levels of glutamic-pyruvic and glutamic-oxalacetic transaminases, total bilirubins, alkaline phosphatase and gamma-glutamyltransferase were assessed before surgery and thereafter weekly until euthanasia, which was performed 6 weeks after biliodigestive connection.RESULTS: Data on 9 dogs were analyzed statistically. The dogs presented with obstructive jaundice after common bile duct ligature, as confirmed by biochemical examination. They showed a statistically significant reduction in cholestasis after biliodigestive connection by jejunal tube interposition and were healthy until the end of the experiment.CONCLUSION: A statistically significant reduction was seen in total bilirubin and canalicular enzymes (alkaline phosphatase and gamma-glutamyltransferase) in the 9 dogs 6 weeks after biliodigestive conviction by jejunal tube interposition.

Effects of low fat and babassu fat diets on nutritional status in obstructive cholestasis in young rats

OBJETIVO: Testar os efeitos de uma dieta com baixo teor de gordura comparada a uma dieta com gordura de babaçu sobre o estado nutricional em ratos jovens com colestase obstrutiva. MÉTODOS: Submetemos 40 ratos divididos em quatro grupos de 10 animais a partir do P21 (21º dia pós-natal) até o P49 a dois dos seguintes tratamentos: ligadura e ressecção do ducto biliar comum ou operação simulada e dieta com baixo teor de gordura (óleo de milho fornecendo 4,5% da quantidade total de calorias) ou dieta com gordura de babaçu (essa gordura fornecendo 32,7% e óleo de milho fornecendo 1,7% da quantidade total de calorias). Foi mensurado o ganho de peso a cada 4 dias do P25 ao P49. A função de crescimento de Verhulst foi ajustada aos valores de ganho de peso. A velocidade e a aceleração de crescimento nos mesmos momentos foram estimadas usando a mesma equação. Foram mensurados: quantidade de ração ingerida e ingestão energética total do P21 ao P49, utilização de energia do P25 ao P49, gordura absorvida e balanço de nitrogênio (BN) do P42 ao P49. A ANOVA com dois fatores e o método de S.N.K para comparações pareadas foram utilizados para estudar os efeitos, sobre as variáveis, da colestase e das dietas e sua interação (p<0,05). RESULTADOS: em ratos com colestase e dieta com baixo teor de gordura, houve maior velocidade de crescimento no P45, maior aceleração de crescimento no P41 e P45, maior utilização de energia, maior percentual de gordura absorvida e maior BN do que em ratos com colestase e dieta com gordura de babaçu. CONCLUSÃO: A dieta com baixo teor de gordura atenua a restrição de crescimento provocada pela colestase e proporciona melhor aproveitamento da dieta e maior incorporação da proteína ingerida do que a dieta com gordura de babaçu.

Ascorbic acid supplementation has a cytoprotective effect on secondary biliary cirrhosis: experimental study in young rats

Objective: To test whether ascorbic acid supplementation has any cytoprotective effect on a model of secondary biliary cirrhosis in young rats.Methods: We studied 40 Wistar rats weaned at the 21st postnatal day. Each group of 10 was subjected to one of the following four treatments, until 49th postnatal day, when they suffered euthanasia: 1) LC-double ligature and resection of the common bile duct and daily administration of ascorbic acid [100 mg/g of body weight (bw)]; 2) LA-double ligature and resection of the common bile duct and daily administration of aqueous vehicle (1 mL/g bw); 3) SC-sham operation and daily administration of ascorbic acid (100 mg/g bw); 4) SA-double ligature and resection of the common bile duct and daily administration of aqueous vehicle (1 mL/g bw). The rats were weighed daily. on the 27th day after the operation they received an intra-peritoneal injection of 1.5 mg/g bw of sodium pentobarbital, and the pentobarbital sleeping time was measured. Blood was collected for serum alanine aminotransferase and aspartate aminotransferase activity measurements, serum albumin and globulin concentrations, and the liver was assessed for liver water and fat content. Data were submitted to two-way ANOVA and paired comparisons between groups were tested using the SNK method. Significance level was set at 0.05.Results: Ascorbic acid supplementation attenuated the effects of cholestasis: decreased the pentobarbital sleeping time, serum globulin, and the liver fat content.Conclusions: Our results corroborate the hypothesis that ascorbic acid supplementation has a cytoprotective effect in secondary biliary cirrhosis.

Lacrimal excretory system sequelae in patients treated for leishmaniasis

A leishmaniose pode destruir os tecidos nasais resultando em alterações da via lacrimal excretora. OBJETIVO: Avaliar a ocorrência de alterações do sistema lacrimal excretor em portadores de leishmaniose na fase de pós-tratamento. MÉTODOS: Foi realizada a avaliação da via lacrimal excretora em 45 portadores de leishmaniose tratada (90 vias lacrimais) pelo teste de Jones I. Treze pacientes (26 ductos nasolacrimais) tiveram o teste de Jones I alterado, tendo sido submetidos a dacriocistografia e endoscopia nasal. RESULTADOS: A maioria dos indivíduos avaliados apresentava a leishmaniose na forma cutânea (64,4%). Entretanto, 69,23% dos indivíduos com alteração do sistema lacrimal excretor apresentavam a forma mucocutânea antes do tratamento. A alteração mais freqüentemente detectada foi ducto nasolacrimal permeável e dilatado (92,30%). Apenas 3,84% (1/26) das vias lacrimais estavam obstruídas. A endoscopia nasal mostrou hipertrofia de corneto (53,84%), desvio de septo (53,84%) e perfuração do septo nasal (23,07%). CONCLUSÃO: em portadores de leishmaniose tratada encontra-se como seqüela mais freqüente no sistema excretor lacrimal as vias lacrimais permeáveis e dilatadas.

Tubo de Lester-Jones: indicações e resultados

OBJETIVO: Avaliar as indicações, resultados e complicações advindas do seu uso. MÉTODOS: Avaliaram-se retrospectivamente 25 pacientes submetidos a 27 conjuntivorrinostomias com colocação de tubo de Lester-Jones. Foram estudados os dados do portador, a etiologia da afecção e as complicações que ocorreram no intra e no pós-operatório. Os dados foram avaliados segundo a freqüência de ocorrência. RESULTADOS: O tubo de Lester-Jones foi usado igualmente em ambos os sexos, mais em indivíduos abaixo dos 10 ou acima dos 50 anos de idade. As causas mais freqüentes para utilização foram a idiopática ou a agenesia congênita de pontos e canalículos. Houve melhora dos sintomas em 88% dos pacientes. Complicações ocorreram em 59,25% dos casos, dentre as quais: extrusão (40,74%) e a migração (14,8%) do tubo. CONCLUSÃO: Apesar das complicações observadas, o índice de cura com a utilização do tubo de Lester-Jones é alto, sendo boa opção para o tratamento das obstruções lacrimais altas.

Dacriocistografia na propedêutica da via lacrimal excretora de adultos

OBJETIVO: Avaliar os achados dacriocistográficos em indivíduos suspeitos de obstrução de vias lacrimais excretoras. MÉTODOS: O estudo foi retrospectivo, tendo sido avaliadas as dacriocistografias de 100 indivíduos adultos, suspeitos de obstrução nasolacrimal, atendidos na Faculdade de Medicina de Botucatu - UNESP. Os dados obtidos foram submetidos à análise estatística descritiva e teste do qui-quadrado. RESULTADOS: A maioria dos pacientes era do sexo feminino e maiores de 60 anos, apresentando obstrução baixa, localizada no seio de Arlt, com saco lacrimal graus 2 ou 3. Vias lacrimais pérvias, com e sem dilatação, também foram encontradas, assim como alterações nasais, como hipertrofia de cornetos. CONCLUSÃO: A dacriocistografia foi importante para diagnosticar o local da obstrução, o grau de dilatação das vias lacrimais, assim como as alterações de estruturas vizinhas. Estas informações sem dúvida são úteis para o planejamento cirúrgico e como indício prognóstico.