Retroperitoneal fibrosis as a postoperative complication following renal transplantation in cats

2021 ◽  
pp. 1098612X2110189
Author(s):  
Brittney J Byer ◽  
Robert J Hardie ◽  
Jonathan F McAnulty
Keyword(s):  
Renal Transplantation ◽  
Ureteral Obstruction ◽  
Retroperitoneal Fibrosis ◽  
Fibrous Tissue ◽  
Clinical Signs ◽  
Abdominal Ultrasonography ◽  
Rejection Reaction ◽  
Transplanted Kidney ◽  
Clinically Significant ◽  
Lymphoplasmacytic Infiltration

Objectives The aim of this report was to describe the clinical signs, diagnostic imaging findings, surgical management, histopathological findings, outcome and possible risk factors for cats that developed retroperitoneal fibrosis (RPF) following renal transplantation. Methods Medical records of cats that underwent renal transplantation and developed clinically significant RPF between 1995 and 2019 were reviewed. Results Eighty-one cats underwent 83 renal transplantations. Of these 81 cats, six developed clinically significant RPF. For all six cats, renal transplantation was performed using cold organ preservation solution and ureteral papilla implantation. Immunosuppression protocol included ciclosporin and prednisolone. All cats had at least one subtherapeutic trough ciclosporin level (<250 ng/ml) in the postoperative period. Cats presented with moderate-to-severe azotemia 39–210 days following renal transplantation. Abdominal ultrasonography and contrast pyelography revealed various degrees of hydroureter and hydronephrosis of the transplanted kidney. Surgical examination revealed a layer of dense fibrous tissue surrounding the transplanted kidney, ureter and bladder resulting in ureteral obstruction. Ureteral obstruction was managed by reimplantation of the proximal ureter or renal pelvis to the bladder. Histopathologic examination of the fibrous tissue and affected portion of the distal ureter revealed fibrous connective tissue with lymphoplasmacytic infiltration and perivascular inflammation suggestive of an autoimmune type reaction. Of the six cats, two died within 5 days after revision surgery, two developed signs consistent with recurrent partial ureteral obstruction (40 and 41 days after revision), one was euthanized 6 years later for an unrelated disease and one was lost to follow-up. Conclusions and relevance The incidence of RPF in this population of cats was relatively low (7%), but still represents a significant cause of morbidity and mortality. The cause of RPF remains unknown, although investigation into suboptimal immunosuppression as a potential cause for local rejection reaction is warranted.

L'imaging della fibrosi retroperitoneale primitiva: Primitive retroperitoneal fibrosis imaging

1998 ◽  
Vol 65 (2) ◽  
pp. 276-286
Author(s):  
N. D'Attoma ◽  
E. Residori ◽  
R. Mariotto ◽  
R. Cerini ◽  
M. Gregianin ◽  
...  
Keyword(s):  
Ureteral Obstruction ◽  
Retroperitoneal Fibrosis ◽  
Imaging Techniques ◽  
Renal Scintigraphy ◽  
Idiopathic Retroperitoneal Fibrosis ◽  
Morphological Approach ◽  
Clinically Significant ◽  
Therapeutic Tools ◽  
Improved Accuracy

Idiopathic retroperitoneal fibrosis (RPF) is characterised by the development of a fibrotic mass in the prelumbar or presacral area which becomes clinically significant when it causes ureteral obstruction. New imaging techniques have improved accuracy of the morphological approach to the disease, but urography and sequential renal scintigraphy are still important for assessing ureteral involvement. The role of imaging techniques is discussed and current diagnostic and therapeutic tools are evaluated.

scholarly journals Bilateral ureterolithiasis in a 7-month-old cat

2021 ◽  
Vol 51 (7) ◽  
Author(s):  
Juliane Elisabeth Gress Paz ◽  
Fernanda Vieira Amorim da Costa ◽  
Gabriela da Cruz Schaefer ◽  
Jaqueline Wisnieski Heck
Keyword(s):  
Renal Failure ◽  
Calcium Oxalate ◽  
Ureteral Obstruction ◽  
Surgical Intervention ◽  
Clinical Signs ◽  
Excretory Urography ◽  
The Body ◽  
Urinary Flow ◽  
Abdominal Ultrasonography ◽  
Mixed Breed

ABSTRACT: Feline ureteral obstruction can have several causes; however, ureterolithiasis has been increasing in occurrence. The restriction of urinary flow induced by the obstruction has harmful consequences to the body and can lead to acute renal failure. Calcium oxalate ureterolithiasis is reported in older cats, aged mean 12 years old. A case of bilateral ureteral obstruction in a 7-month-old mixed breed cat is described in this report. Imaging tests such as abdominal ultrasonography, radiography and excretory urography were performed to determine the diagnosis. The surgical procedure of bilateral ureterotomy was then performed, which allowed the improvement of the urinary flow of both kidneys and the resolution of clinical signs caused by uremia. The quantitative analysis of both uroliths revealed the composition of 100% monohydrate calcium oxalate. Calcium oxalate stones can also cause ureteral obstruction in young cats; although, are less common in this age. When conservative treatment fails, surgical intervention becomes necessary for the rapid return of renal function. To author’s knowledge this is the first report of a ureterolithiasis caused by calcium oxalate in a young cat.

Cystic Bone Lesions in Horses and Humans: A Comparative Review

1998 ◽  
Vol 11 (01) ◽  
pp. 08-18 ◽  
Author(s):  
C. W. McIlwraith ◽  
J. A. Auer ◽  
Brigitte von Rechenberg
Keyword(s):  
Recurrence Rate ◽  
Subchondral Bone ◽  
Fibrous Tissue ◽  
Clinical Signs ◽  
Bone Lesions ◽  
Anatomical Location ◽  
Cystic Lesions ◽  
Bone Cysts ◽  
Biological Behaviour ◽  
Comparative Review

SummaryCases of cystic bone lesions in horses and humans were reviewed in the literature. These lesions are radiolucent areas of bone, recognized as subchondral cystic lesions in the horse (SCL), intra-osseous ganglia (IOG), subchondral bone cysts secondary to osteoarthrosis (OAC), and unicameral bone cysts (UCB) in humans. Their morphology is quite similar, consisting of lesions with a distinct cyst wall, and a cavity filled with fibrous tissue and yellowish mucoid fluid. The lesions are surrounded by sclerotic bone and can be easily diagnosed radiographically. SCL, IOG and OAC occur in the subchondral bone close to the adjacent joint, whereas UCB occur in the metaphysis of long bones. Their aetiology and pathogenesis is still unknown, although primary damage to the subchondral bone, cartilage or local blood supply and growth disturbances are discussed. In this review 703 lesions of SCL in horses, 289 lesions of IOG and 1460 lesions of UCB in humans were compared in their anatomical location and clinical signs. SCL and OAC resembled each other with respect to anatomical location. A correlation of affected bones could not be found for all four groups. Clinical presentation concerning age was most similar for SCL and UCB with both lesions mainly occurring in young individuals. Gender predominance of males was present in SCL, IOG and UCB. Clinical diagnosis was either incidental, or connected with intermittent pain in all lesions except for OAC. Additionally, the lesions were also found in conjunction with degenerative joint disease (SCL, OAC) or pathological fractures (UCB). Cystic bone lesions were either treated conservatively, surgically with curettage alone, curettage in combination with grafting procedures, or intra-lesional application of corticosteroids. SCL and UCB were similar in their biological behaviour concerning their slow response to the therapy and relatively high recurrence rate. None of the cystic bone lesions were comparable, and a common aetiology and pathogenesis could not be found.In a literature review cases of cystic bone lesions in horses and humans were compared with the goal to find a common aetiology and pathogenesis. Cystic bone lesions occur in horses as subchondral cystic lesions (SCL), and in humans as either intra-osseous ganglia (IOG), subchondral cystic lesions secondary to osteoarthrosis (OAC) or unicameral bone cysts (UCB). IOG and OAC compare with SCL mainly in the anatomical location. IOG and SCL resemble each other in size, clinical signs and histology, whereas UCB and SCL show a similar biological behaviour regarding their therapeutic response and recurrence rate. None of the cystic bone lesions in humans were comparable to the SCL in horses in all aspects. A common aetiology and pathogenesis could not be established.

scholarly journals Feline abdominal ultrasonography: what’s normal? what’s abnormal? The adrenal glands

2021 ◽  
Vol 23 (1) ◽  
pp. 33-49 ◽  
Author(s):  
Sally Griffin
Keyword(s):  
Adrenal Glands ◽  
Ultrasound Examination ◽  
Abdominal Ultrasound ◽  
Evidence Base ◽  
Vital Role ◽  
Abdominal Ultrasonography ◽  
Operator Experience ◽  
High Resolution Images ◽  
Clinically Significant ◽  
Diagnostic Work

Practical relevance: Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. Ultrasound examination of the adrenal glands can provide important information pertaining to several conditions including hyperaldosteronism and hyperadrenocorticism. Clinical challenges: Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even for the experienced ultrasonographer, differentiating between incidental findings, such as adrenal mineralisation, and clinically significant pathological changes can be challenging. Aim: This review, part of an occasional series on feline abdominal ultrasonography, discusses the ultrasonographic examination of the normal and diseased adrenal glands. Aimed at general practitioners who wish to improve their knowledge of and confidence in feline abdominal ultrasound, this review is accompanied by high-resolution images and videos available online as supplementary material. Equipment: Ultrasound facilities are readily available to most practitioners, although the use of ultrasonography as a diagnostic tool is highly dependent on operator experience. Evidence base: Information provided in this article is drawn from the published literature and the author’s own clinical experience.

scholarly journals Hemorrhagic abdominal pseudocyst following ventriculoperitoneal shunt: a case report

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hong-Cai Wang ◽  
Yi-Lei Tong ◽  
Shi-Wei Li ◽  
Mao-Song Chen ◽  
Bo-Ding Wang ◽  
...  
Keyword(s):  
Fibrous Tissue ◽  
Clinical Signs ◽  
Chronic Subdural Hematoma ◽  
Normal Pressure ◽  
Cystic Mass ◽  
Shunt Revision ◽  
Subdural Effusion ◽  
Palpable Mass ◽  
Vp Shunt ◽  
Abdominal Pseudocyst

Abstract Background Abdominal cerebrospinal fluid (CSF) pseudocyst is an uncommon but important complication of ventriculoperitoneal (VP) shunts. While individual articles have reported many cases of abdominal CSF pseudocyst following VP shunts, no case of a hemorrhagic abdominal pseudocyst after VP shunts has been reported so far. Case presentation This article reports a 68-year-old woman with a 4-month history of progressive abdominal pain and distention. She denied any additional symptoms. A VP shunt was performed 15 years earlier to treat idiopathic normal pressure hydrocephalus and no other abdominal surgery was performed. Physical examination revealed an elastic palpable mass in her right lower abdomen, which was dull to percussion. Abdominal computed tomography (CT) scan indicated a large cystic collection of homogenous iso-density fluid in the right lower abdominal region with clear margins. The distal segment of the peritoneal shunt catheter was located within the cystic mass. Abdominal CSF pseudocyst was highly suspected as a diagnosis. Laparoscopic cyst drainage with removal of the whole cystic mass was performed, 15-cm cyst which found with thick walls and organized chronic hematic content. No responsible vessel for the cyst hemorrhage was identified. No further shunt revision was placed. Histological examination showed that the cyst wall consisted of outer fibrous tissue and inner granulation tissue without epithelial lining, and the cystic content was chronic hematoma. The patient had an uneventful postoperative course and remained asymptomatic for 8-mo follow-up. Conclusion To the best of our knowledge, this is the first report of hemorrhagic onset in the abdominal pseudocyst following VP shunt. Such special condition can accelerate the appearance of clinical signs of the abdominal pseudocyst after VP shunts, and its mechanisms may be similar to the evolution of subdural effusion into chronic subdural hematoma (CSDH).

scholarly journals Foreign Body Reaction Associated With Artificial LARS Ligaments: A Retrieval Study

2018 ◽  
Vol 6 (12) ◽  
pp. 232596711881160 ◽  
Author(s):  
Zachary Paul Sinagra ◽  
Alan Kop ◽  
Moreica Pabbruwe ◽  
Jeremy Parry ◽  
Gavin Clark
Keyword(s):  
Foreign Body ◽  
Foreign Body Reaction ◽  
Fibrous Tissue ◽  
Case Series ◽  
Significant Degree ◽  
Level Of Evidence ◽  
Tissue Ingrowth ◽  
Artificial Ligaments ◽  
Clinically Significant ◽  
Improved Design

Background: Artificial ligaments have been developed and used in the treatment of ligamentous injuries since the 1970s. The early generation of artificial ligaments showed promising short-term results but resulted in high rates of rupture and inflammatory reaction in the surrounding tissues. Purpose: To determine whether the use of Ligament Augmentation and Reconstruction System (LARS) ligaments is associated with the development of intra-articular foreign body reaction. Study Design: Case series; Level of evidence, 4. Methods: LARS ligaments were explanted from 15 patients under 6 consultant orthopaedic surgeons at 8 surgical centers. Of these, 14 explanted samples were sent for macroscopic and histological analysis, with the 1 remaining sample sent for scanning electron microscopy, to assess for inflammatory change as well as the degree of fibrous tissue ingrowth. Results: We observed a foreign body reaction in 10 of 14 explanted LARS ligaments. Seven samples demonstrated fibrous tissue ingrowth, with 5 producing only focal or incomplete ingrowth. The 2 samples with extensive fibrous coverage were completely free of any foreign body reaction, while all 5 remaining samples with only focal or partial fibrous ingrowth were associated with at least some degree of harmful immune response. Conclusion: The LARS ligament is still associated with a clinically significant degree of foreign body reaction despite the LARS Company’s efforts to reduce complications through improved design. The development and completion of fibrous tissue ingrowth may work to reduce the occurrence of a foreign body reaction.

scholarly journals Non-inflammatory aortoiliac aneurysm with ureteral obstruction and consequent hydronephrosis: Case report

2012 ◽  
Vol 140 (1-2) ◽  
pp. 91-93
Author(s):  
Srdjan Babic ◽  
Djordje Radak ◽  
Predrag Matic ◽  
Vladimir Kovacevic ◽  
Dario Jocic
Keyword(s):  
Ureteral Obstruction ◽  
Retroperitoneal Fibrosis ◽  
Obstructive Uropathy ◽  
Elevated Serum ◽  
Multislice Ct ◽  
Domestic Literature ◽  
Aortoiliac Aneurysm ◽  
Ct Findings ◽  
Atherosclerotic Aneurysm ◽  
Vascular Status

Introduction. The natural course of abdominal aneurysms is progressive expansion, rupture, embolisation, thrombosis and compression of the visceral organs. The majority of papers report that inflammatory aortic and iliac aneurysms are associated with perianeurysmal and retroperitoneal fibrosis that ultimately results in the structural compromise of the urinary tract. Ureteral obstruction occurs in 20% to 71% of cases and approximately one half of these patients will present with obstructive uropathy. Most patients with inflammatory aneurysm are symptomatic, with elevated serum inflammatory markers, and characteristic multislice CT findings including a thickened aortic wall and a mass of periaortic inflammatory tissue. Case Outline. A 70-year-old man was admitted at the Vascular Surgery Clinic ?Dedinje?, Belgrade, because of ultrasonically verified asymptomatic aortoiliac aneurysm. Multisclice CT findings showed left urethral dilatation and hydronephrosis secondary to extrinsic ureteral obstruction due to aortoiliac aneurysm. CT findings, laboratory tests and finally, histopathologic examination showed atherosclerotic aneurysm without inflammation and retroperitoneal fibrosis. The patient was successfully treated with surgical resection of the aneurysm and aortobiiliac reconstruction with ?Y? prosthesis. Conclusion. We present a rare case of ureteral obstruction secondary to atherosclerotic aneurysm which, to our knowledge, has not been previously described in the domestic literature. A successful operative repair was performed. Postoperative course was uneventful and the patient was discharged on the seventh day after the surgery with normal vascular status and renal function.

Intestinal lymphoma in a Boxer breed dog – case report

2019 ◽  
Vol XXIV (142) ◽  
pp. 72-82
Author(s):  
Sayonara da Luz Ferro ◽  
Fernanda Jönck ◽  
Marta Cristina T. Heckler ◽  
Ewerton Cardoso ◽  
Mateus Rychescki ◽  
...  
Keyword(s):  
Weight Loss ◽  
Abdominal Cavity ◽  
Clinical Signs ◽  
Exploratory Laparotomy ◽  
Needle Aspiration ◽  
Free Fluid ◽  
Intestinal Lymphoma ◽  
Mesenteric Lymph Nodes ◽  
Abdominal Ultrasonography ◽  
Tissue Biopsy

Intestinal lymphoma is the second most common form of lymphoma in dogs. It is characterized by the presence of neoplastic lymphocytes in the gastrointestinal tract or mesenteric lymph nodes. The chief clinical signs are vomiting, diarrhea, anorexia and weight loss. The diagnosis is made through fine needle aspiration and cytology, or by tissue biopsy and histopathology, and chemotherapy is the treatment of choice. We report a case of intestinal lymphoma in a five years old Boxer, presented with history of hematochezia and lethargy of 7 days duration, and 20 days of anorexia and persistent weight loss. Abdominal ultrasonography revealed free fluid in the abdominal cavity, and an intestinal mass. Exploratory laparotomy was performed and a tissue biopsy was performed. Histopathology confirmed the diagnosis of intestinal lymphoma, but the patient died during the surgical procedure.

Evaluation of diagnostic and prognostic usefulness of abdominal ultrasonography in dogs with clinical signs of acute pancreatitis

2021 ◽  
Vol 259 (6) ◽  
pp. 631-636
Author(s):  
Eleonora Gori ◽  
Alessio Pierini ◽  
Ilaria Lippi ◽  
Simonetta Citi ◽  
Tommaso Mannucci ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Clinical Signs ◽  
Abdominal Ultrasonography

A CASE OF BILATERAL RENAL B-CELL LYMPHOMA WITH UVEITIS AND SECONDARY POLYCYTHEMIA IN A JACK RUSSELL TERRIER

2021 ◽  
pp. 1-8
Author(s):  
Shu-Fang Yang ◽  
Heng-Leng Yang ◽  
Hui-Wen Chang ◽  
Yu-Han Hsieh ◽  
Peng-Chen Wang ◽  
...  
Keyword(s):  
B Cell ◽  
Vision Loss ◽  
Clinical Signs ◽  
B Cell Lymphoma ◽  
Cell Marker ◽  
Abdominal Ultrasonography ◽  
General Physical Examination ◽  
General Physical ◽  
The Right ◽  
End Stage

An 8-year-old, castrated male, Jack Russell Terrier was presented with clinical signs of uveitis and glaucoma in the right eye (oculus dexter (OD)) for 2–3 months. Ophthalmic examination revealed OD episcleral congestion, corneal vascularization, aqueous flare, iris bombe, and vision loss. OD glaucoma and uveitis were under control by medical treatment. After 8 months, the dog had acute uveitis in the left eye (oculus sinister (OS)). General physical examination, blood examinations, radiography, and urinalysis were unremarkable. No improvement was observed after for 1 month of uveitis treatment, and more examinations were strongly suggested. Abdominal ultrasonography revealed several hypoechoic masses or cysts on both kidneys. Computed tomography (CT) showed diffuse nonenhancing hypodense patches in both kidneys. Renal tumor was highly suspected, but biopsy was declined by the owner. Ten days after CT examination, the dog suddenly developed anorexia, weakness, uremia, hyperkalemia, and polycythemia. The dog was euthanatized because of the worsening clinical condition, poor prognosis, and financial constraints, and both kidneys were biopsied for histopathology. Immunohistochemically, the neoplastic cells were positive for B-cell marker (CD20) and negative for T-cell marker (CD3). Bilateral renal B-cell origin lymphoma was diagnosed by histologic and immunophenotyping examinations. In conclusion, bilateral renal lymphoma may be diagnosed with no systemic signs except bilateral uveitis. Renal function impairment was acutely developed with severe clinical signs at the end stage of the disease. Early, aggressive, complete examinations, and treatments are strongly recommended.

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