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Copyright of Prometeus: Filosofia em Revista is the property of Prometeus: Filosofia em Revista and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Cholangiocarcinoma is an epithelial cell malignancy arising at various locations within the biliary tree. Primary liver tumors can be classified morphologically as solid, when a single large tumor involves only one liver lobe; nodular, when multiple tumors are located in different liver lobes; diffuse, when either multifocal nodular changes occur in different liver lobes or when diffuse changes occur throughout the liver. Surgery is the treatment of choice for these tumors because there is no established, effective chemotherapy protocol. This paper reports on the management of a dog with diffuse cholangiocarcinoma. Case: A 13-year-old female, castrated Pinscher, weighting 6 kg, was admitted at the Veterinary Medical Teaching Hospital of the Federal University of Rio Grande do Sul (UFRGS) with clinical signs of abdominal distension and dyspnea that had started one month ago. The patient had been subjected to total unilateral mastectomy to remove an adenocarcinoma. At clinical examination, the animal presented anemia, an area of silence during pulmonary auscultation on the right hemithorax, and hepatomegaly. Because of the chronicity and nonspecific signs, additional tests were requested. Abdominal ultrasound exam showed hepatomegaly with irregular echotexture; cavity areas scattered throughout the organ, especially by the right medial lob; discrete presence of free abdominal fluid. Thoracic radiography showed increased radiopacity in the medial and caudal right hemithorax, suggesting metastasis. Laboratory tests included a complete blood count (normocytic mycrocytic anemia), an albumin count (27.49 g/L), an alanine amino-transferase test (77.40 U/L), an alkaline phosphatase test (284.94 U/L), a creatinine test (0.81 mg/dL), a conjugated bilirubin test (0.1 mg/dL), a not conjugated bilirubin test (0.1 mg/dL), and a total bilirubin test (0.2 mg/dL). After blood transfusion, a hepatic lobectomy was performed. An incision was made along the ventral midline. A tumoral mass, approximately 20 cm in diameter, was observed in the right medial lobe, as well as diffuse changes throughout all hepatic lobes. A total lobectomy was performed by applying the mass ligation technique by placement of a circumferential ligature around the liver hilus. The abdominal cavity was sutured routinely. Histopathological examination showed primary cholangiocarcinoma. The animal had excellent postoperative recovery after six days. Subsequently, the patient again succumbed to hepatomegaly, ascites, anemia, and lethargy, and the owner chose to euthanize the patient and did not authorize a necropsy. Discussion: The cholangiocarcinoma was classified as primary and diffuse because of the macroscopic characteristics of the liver, since there were diffuse changes throughout the organ. Surgical excision was the treatment of choice. Although the prognosis was better in the early stages, lobectomy was chosen in order to improve the patient's respiratory condition and, consequently, improve the quality of life. There were no surgical complications and the patient presented good postoperative recovery. After 60 days of the surgical procedure, clinical signs recurred (anemia, hyporexia and abdominal distension) and euthanasia was performed. Hepatic lobectomy in an animal with advanced stage cholangiocarcinoma provided good quality of life for a period of 60 days. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction: Several factors have made hepatectomy an increasingly safe surgery and new drugs allowed surgical treatment for patients who initially were not candidates for resection. Lesions often require resection, which can be performed by open, laparoscopic, or robotic assisted hepatectomy. Aim: Compare the surgical techniques in open, laparoscopic, and robotic assisted hepatectomy for resection of liver tumors. Methods: Literature review based on scientific papers published on Lilacs/Pubmed/Scielo in the last 17 years regarding the indications of these techniques for liver tumor resections and on papers comparing such techniques. Results: The comparative study shows the benefits of laparoscopic surgery over open surgery, such as smaller incisions, less postoperative pain, shorter recovery time, smaller immune and metabolic response, and quicker restoration of oral ingestion as well as lower morbidity rates. However, the need for a specialized surgical team and the reduction in handling area still remain as disadvantages in the laparoscopic technique. It is yet not clear whether robotic assistance presents considerable benefits over the laparoscopic technique considering that high acquisition and maintenance costs are limiting factors. Conclusion: Despite all challenges, laparoscopic hepatectomy presents many benefits over open surgery. The robotic assisted technique is still in evolution as many centers in the world perform hepatic resections with the platforms but only after a thorough patient selection. Thus, laparoscopy stands as the best option, unless there is some contraindication to the procedure.

Copyright of Pesquisa Veterinaria Brasileira is the property of Colegio Brasileiro de Patologia Animal - CBPA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Infectious canine hepatitis (ICH) is a systemic viral disease of dogs. It affects mainly unvaccinated dogs under the age of six months. Although clinical signs of ICH are not specific, the necropsy findings are sufficient to allow a presumptive diagnosis associated with epidemiology and clinical signs. Clinician should suspect the disease when two years-old dogs or younger present acute death with abdominal pain, neurological disorders and signs of bleeding. The objective of this study is to report an unusual case of ICH, describing the clinical and pathological findings in a geriatric dog with the disease. Case: A female Basset Hound dog, 9 year-old, was presented with intense vomiting and diarrhea in the last day. The animal was not vaccinated there was two years. The blood count revealed moderate leukocytosis by neutrophils and deviation to the left and to the right, and monocytosis, besides lymphopenia and eosinopenia. It was also possible to observe hyperproteinemia and plasma intensely jaundiced. The biochemical examination showed alterations in liver and kidney parameters. After three days of hospitalization, the patient was euthanized and submitted for necropsy. Macroscopic findings consisted of increased dark red liver, and fibrin strands in the capsular surface. There was a bloody fluid in the small intestine and stomach. Serous small intestine showed granular appearance. Kidneys were dark red aspect. There was ecchymosis in the lung. Histopathological analysis of the liver showed severe hemorrhage with multifocal hepatocellular necrosis randomized and intense mixed inflammatory infiltrate composed of lymphocytes, plasma cells and macrophages, mainly in the periportal region with presence of intranuclear inclusions in hepatocytes, which were amphophilic (characteristic of adenovirus); some of them met all the core, but most showed clear halo between inclusion and the limit of the nuclear membrane. Kidneys had rare amphophilic intranuclear inclusion bodies in renal glomerulus. Discussion: Most authors recognize ICH mainly affecting young animals (up to two years). Factors related to vaccination as poor preservation of the product, mode of application and improper intervals between applications; or attached to the patient, such as stress and concomitant diseases, will contribute to the occurrence of the infection. The reported dog was delayed vaccination program there was two years ago, which may also have interfered with immune status. The dog in this case had clinical suspicion of liver disease, and there was not initial suspicion of ICH, which can be related to the difficulty of making a clinical diagnosis of this disease, since the signs are nonspecific. This fact reinforces the importance of the definitive diagnosis of ICH that be confirmed by histopathology and/or supplementary diagnosis. The blood count of the patient showed an inflammatory WBC count with possible influence of stress. Furthermore, hyperproteinemia was related to the dehydration caused by vomiting and diarrhea and/or antigenic stimulation. In this patient, macroscopic findings were suggestive of HIC, while histological analysis confirmed our suspect. The diagnosis of the disease, in this case, was possible by the histopathological analysis that allowed the identification of intranuclear inclusion bodies in the liver and kidneys, which are characteristic of the canine adenovirus type 1. [ABSTRACT FROM AUTHOR]

Background: Rhodococcus equi is a Gram-positive, aerobic, cosmopolitan coccobacillus present in the soil and in feces of birds and a large variety of domestic mammals. It is the etiologic agent that commonly causes pneumonia in foals. This case report describes the clinical signs, lesions and the microbiological analysis of samples collected from three goats infected with Rhodococcus equi in a farm in southern Brazil. Cases: Three Boer goats died one week after presenting clinical signs that included: diarrhea, ruminal atony and anorexia (Goat 1); abortion, progressive weight loss, appetite loss, pale mucosas and tachycardia (Goat 2); and submandibular edema and anemia (Goat 3). Upon necropsy, it was shown that all goats presented multiple liver nodes between 0.5 and 3.0 cm in diameter. When sectioned these nodes presented yellowish contents that were not resistant. Additionally, Goat 2 presented nodes with caseous contents in mesenteric lymph nodes and lungs, which were similar to those observed in the liver. Upon necropsy, samples of organs were collected and fixed in 10% formaldehyde for histopathological analyses and kept under refrigeration for microbiological analyses. Histopathological analyses of liver, lung and lymph node of all goats revealed the presence of multifocal necrotic areas associated with the deposition of basophilic granular material (mineralization) surrounded by intense macrophage and neutrophil infiltration. Besides, moderate amounts of giant cells were also observed. Fite-Faraco staining showed coccobacillary structures in cytoplasm of macrophages and giant cells. The histopathological changes observed in this study are consistent with lymphadenitis, hepatitis and pyogranulomatous pneumonia. For the microbiological examination, samples were inoculated by direct imprint on Blood agar and MacConkey agar, and in Brain Heart Infusion enrichment broth at 37°C for between 24 h and 48 h. Subsequently, small, shiny, non-hemolytic mucoid colonies were observed, which were then submitted to Gram staining. Isolated colonies underwent biochemical differentiation. Rhodococcus equi was isolated by direct microscopy and the Gram method. Discussion: Rhodococcus equi sporadically affects goats, causing multiple hepatic and pulmonary caseous nodules. These lesions were observed in the samples examined in the present study. Differential diagnosis of rhodococcosis in goats includes caseous lymphadenitis and tuberculosis, although the etiologic agents of these diseases were not isolated in this study. In spite of the fact that Rhodococcus equi is isolated from the feces of herbivores, especially equines, no such animals were reared in the farm where the goats analyzed lived. Goats have been farmed in the property since 2006. It was not possible to determine the virulence of the agent. Nevertheless, new cases of rhodococcosis in goats indicate that infection by Rhodococcus equi may be more frequent in ruminants than it is expected, and play an important role in the differential diagnosis of caseous lymphadenitis. The detailed description of clinical signs and of the macroscopic and microscopic lesions associated with the isolation of the infectious agent confirm the diagnosis of rhodococcosis, and allow the veterinary doctor to list the possibilities in the differential diagnosis of the disease in goats with other granulomatous and pyogranulomatous diseases. [ABSTRACT FROM AUTHOR]

The first application of laparoscopic liver surgery consisted of wedge liver biopsies or resection of peripheral lesions, mostly benign. More recently, reports of anatomic left and right hepatectomy have been seen in the literature. Expertise in some centers has evolved to such an extent that even living related donor hepatectomy has been performed. The aim of this paper is to report a laparoscopic right hepatectomy and describe in detail the surgical technique employed. To our knowledge this is the first case performed in Brazil totally laparoscopically. The surgery followed four distinct phases: complete mobilization of the liver; hilum dissection with encircling of right portal vein and right hepatic artery, caval dissection using linear vascular stapler to divide right hepatic vein and parenchymal transection with harmonic shears and firings of linear staplers are used to divide segmental 5 and 8 branches of middle hepatic vein. The liver specimen was removed by Pfannenstiel incision. Intraoperative blood loss was estimated in 120 ml with no need for blood transfusion. Hospital stay was 5 days. Laparoscopic right hepatectomy is feasible, technically demanding but can be safely accomplished by surgeons who have experience in advanced laparoscopic procedures and open hepatic surgery. In Brazil laparoscopic liver surgery is still in its first years and there is a lack of technical description of this complex procedure.

The intra-hepatic glissonian approach has been considered an advance in the modern hepatic surgery by allowing a safe resection, with minor bleeding and maximum preservation of hepatic tissue. This paper explores the history, the anatomy, the techniques and how to perform and understand the intra-hepatic glissonian approaches.

Cholangiocarcinoma of the hepatic hilum is a seldom curable lesion. Those patients are often managed with prostheses. Cholangiojejunostomy on the third segment of the liver seems to offer effective biliary drainage with better quality of life compared to other forms of palliation. The aim of this paper is to report a successful case of a patient with irressectable biliary tumor submitted to a surgical biliary drainage.