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Hidronefrose E Hidroureter Unilateral Secundários A Obstrução Ureteral Terminal De Origem Indeterminada - Estudo De Caso Clínico
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Abstract(s)
Um canídeo Husky Siberiano, macho castrado de 3 anos de idade, foi referenciado ao Hospital
Veterinário de Saint MarBn com história de 3 semanas de disúria associada a polaquiúria, estrangúria
e hematúria. O exame clínico revelou um abdómen dilatado e doloroso na sua porção cranial direita,
bem como taquipneia e taquicardia.
O hemograma evidenciou leucocitose, neutrofilia e monocitose, enquanto a bioquímica sérica
demonstrou azotemia.
Na ecografia abdominal foi detetado uma efusão no quadrante abdominal direito e um aumento da
dimensão do rim e do ureter direitos, com perda da arquitetura renal. A análise do líquido livre permiBu
classificá-lo como uroabdómen. A TC confirmou os achados ecográficos de obstrução ureteral unilateral
associada a um hidroureter e hidronefrose secundários.
Foi efetuada uma ureteronefrectomia por laparotomia. O rim e o ureter removidos apresentavam-se
macroscopicamente aumentados e com conteúdo líquido. A análise histopatológica do rim e ureter
removidos demonstrou uma lesão quísBca renal difusamente fibrosada associada a um ureter dilatado
e hiperplasia marcada do epitélio de transição, com presença de estenose por fibrose do ureter,
possivelmente de origem congénita.
Com o presente caso pretende-se contribuir para o conhecimento desta condição no cão e salientar a
necessidade do relato e exposição à comunidade ciennfica de todos os casos de hidronefrose e de
hidroureteres anpicos, a fim de melhorar as estratégias de diagnósBco precoce, tratamento e
consequentemente prognósBco.
A 3-year-old neutered male Siberian Husky was referred to Saint MarBn's veterinary hospital with a 3- week history of dysuria associated with pollakiuria, stranguries and haematuria. Clinical examinaBon revealed an enlarged and painful abdomen on the right, more marked in the right cranial abdomen, tachypnoea and tachycardia. The blood count showed leucocytosis, neutrophilia and monocytosis, while the biochemistry showed azotaemia. Abdominal ultrasound showed an effusion in the right abdominal quadrant and an increase in the size of the right kidney and ureter, with loss of renal architecture. A puncture and subsequent analysis of the fluid classified it as uroabdomen. The CT scan confirms the ultrasound suspicions of unilateral ureteral obstrucBon associated with a hydroureter and, consequently, hydronephrosis. Was performed a ureteronephrectomy by laparotomy. The kidney and ureter removed were macroscopically enlarged, with fluid content. Histopathological analysis of the removed kidney and ureter showed a diffusely fibrous renal cysBc lesion associated with a dilated ureter and marked hyperplasia of the transiBonal epithelium, with presence of stenosis by fibrosis of the ureter, possibly of congenital origin. The aim of this case study is to contribute to the knowledge of this condiBon in dogs and to highlight the need to report and expose to the scienBfic community all cases of hydronephrosis and atypical hydroureters, in order to improve strategies for early diagnosis, treatment and consequently prognosis.
A 3-year-old neutered male Siberian Husky was referred to Saint MarBn's veterinary hospital with a 3- week history of dysuria associated with pollakiuria, stranguries and haematuria. Clinical examinaBon revealed an enlarged and painful abdomen on the right, more marked in the right cranial abdomen, tachypnoea and tachycardia. The blood count showed leucocytosis, neutrophilia and monocytosis, while the biochemistry showed azotaemia. Abdominal ultrasound showed an effusion in the right abdominal quadrant and an increase in the size of the right kidney and ureter, with loss of renal architecture. A puncture and subsequent analysis of the fluid classified it as uroabdomen. The CT scan confirms the ultrasound suspicions of unilateral ureteral obstrucBon associated with a hydroureter and, consequently, hydronephrosis. Was performed a ureteronephrectomy by laparotomy. The kidney and ureter removed were macroscopically enlarged, with fluid content. Histopathological analysis of the removed kidney and ureter showed a diffusely fibrous renal cysBc lesion associated with a dilated ureter and marked hyperplasia of the transiBonal epithelium, with presence of stenosis by fibrosis of the ureter, possibly of congenital origin. The aim of this case study is to contribute to the knowledge of this condiBon in dogs and to highlight the need to report and expose to the scienBfic community all cases of hydronephrosis and atypical hydroureters, in order to improve strategies for early diagnosis, treatment and consequently prognosis.
Description
Keywords
Cão Disúria Hidronefrose Hidroureter Uroabdómen Ureteronefrectomia Dog Dysuria Hydronephrosis Hydroureter Uroabdomen Ureteronephrectomy