方法:介绍了一只7岁绝育的雌性家养长毛猫,以进一步调查可疑的肝胆疾病。血清1,2-o-二月桂酰-rac-甘油-3-戊二酸-(6'-甲基间苯二酚)酯脂肪酶和肝胆酶的增加,同时伴有低白蛋白血症,有血液生化记录。腹部超声检查结果与急性胰腺炎一致,胰管内可见多个胰体。对疑似三裂炎的治疗是用水解蛋白质饮食开始的,阿莫西林-克拉维酸,肝脏保护剂和丁丙诺啡。53天后,患者出现高钙血症和梗阻性胰管结石,并被安乐死.尸检显示重度慢性活动性胰腺炎伴中度慢性淋巴细胞,浆细胞性胆管癌和轻度慢性淋巴细胞-浆细胞性十二指肠肠炎(三联炎)。胰管内存在多个碳酸钙胰体导致胰管阻塞。
结论:胰腺结石在猫中非常罕见,到目前为止只有五份报告.在人类医学中,胰管结石通常是慢性胰腺炎的后遗症,在高达50-90%的患者中看到。然而,在猫中胰管结石的病因,事实上是慢性胰腺炎,知之甚少。该报告描述了猫的梗阻性胰石症,并在组织病理学上证实了三联炎,并且是患有梗阻性胰石症的猫的高钙血症的第一份报告。这进一步增加了证据基础,即胰管结石可能具有与人类相似的发病机理,并且可以继发于猫的慢性胰腺炎。
METHODS: A 7-year-old neutered female domestic longhair cat was presented for further investigation of suspected hepatobiliary disease. Increases in serum 1,2-o-dilauryl-rac-glycero-3-glutaric acid-(6\'-methylresorufin) ester lipase and hepatobiliary enzymes, with concurrent hypoalbuminaemia, were documented on blood biochemistry. Abdominal ultrasonography findings were consistent with acute pancreatitis with multiple pancreatoliths visualised within the pancreatic duct. Treatment for suspected triaditis was initiated with a hydrolysed protein diet, amoxicillin-clavulanate, hepatoprotectants and buprenorphine. Fifty-three days later, the patient presented with hypercalcaemia and obstructive
pancreatolithiasis, and was euthanased. Post-mortem examination revealed severe chronic active pancreatitis with moderate chronic lymphocytic, plasmacytic cholangiohepatitis and mild chronic lymphocytic-plasmacytic duodenal enteritis (triaditis). Multiple calcium carbonate pancreatoliths present within the pancreatic ducts had resulted in pancreatic duct obstruction.
CONCLUSIONS: Pancreatolithiasis is a very rare condition in cats, with only five reports to date. In human medicine,
pancreatolithiasis is often a sequala to chronic pancreatitis, seen in up to 50-90% of patients. However, in cats the aetiology of pancreatolithiasis, and indeed chronic pancreatitis, is poorly understood. This report describes a case of obstructive pancreatolithiasis in a cat with histopathological confirmation of triaditis and is the first report of hypercalcaemia in a cat with obstructive
pancreatolithiasis. This further adds to the evidence base that
pancreatolithiasis may have a similar pathogenesis to humans and can develop secondarily to chronic pancreatitis in cats.