首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 31 毫秒
1.

Background

Endoscopy is performed for direct inspection of the mucosa and acquisition of biopsies in dogs with inflammatory bowel disease (IBD).

Aim

To evaluate the interobserver agreement in the endoscopic assessment of duodenal mucosa in dogs with IBD.

Methods

Thirty‐five archived endoscopic images of grossly normal (n = 6) and inflamed (n = 29) duodenal mucosa were displayed to 3 expert and 5 trainee endoscopists. Each image was assessed independently by endoscopists for mucosal abnormalities using established indices (of hyperemia, granularity, friability, lymphatic dilatation, and erosions) or interpreted as normal mucosa (trial 1). A repeated trial (trial 2) was performed with the same images presented in random order 1 month later, and accompanied by a visual template.

Results

There was slight interobserver agreement in initial mucosal assessment for expert and trainee endoscopists in trial 1 (kappa ≤ 0.02, P > .05). Interobserver agreement improved in trial 2 for both expert and trainee endoscopists (kappa = 0.2, P > .05) for experts and (P < .05) for trainees. There was a significant (< .01) improvement in trainee endoscopy scores of lesions from trial 1 to trial 2. Regression analysis showed a significant (P < .01) difference between expert versus trainee endoscopy scores in trial 1. Repeat lesion assessment aided by use of a visual template (trial 2) improved the overall scores of trainee endoscopists to near that of expert endoscopists (P = .06).

Conclusions and Clinical Importance

Interobserver agreement of IBD mucosal appearance from endoscopic findings benefitted from operator experience.  相似文献   

2.

Background

The current tendency when investigating dogs with chronic upper gastrointestinal signs is to perform endoscopy and biopsy only the duodenum. This approach could lead to overlooking important ileal lesions and affect the clinical management.

Objectives

To compare concurrent duodenal and ileal endoscopic biopsies in dogs with chronic enteropathies and evaluate their correlation with clinicopathologic findings.

Animals

Thirty‐eight dogs with chronic enteropathies.

Methods

Duodenal and ileal biopsies were retrospectively reviewed. Nine histologic variables, 5 structural (villous stunting, epithelial injury, crypt distension, lacteal dilatation, and mucosal fibrosis) and 4 inflammatory (intraepithelial lymphocytes, lamina propria lymphocytes and plasma cells, eosinophils, and neutrophils) were scored. Clinical severity scores and relevant clinicopathologic variables were evaluated.

Results

There was only slight agreement between duodenal and ileal histologic scores (κ = 0.003). There was slight agreement between the presence of any of the morphological and inflammatory variables, with the exception of mucosal fibrosis (κ = 0.44). Statistically significant correlation was found between clinical severity and duodenal crypt distension (P = .031), ileal lacteal dilatation (P = .038), and ileal mucosal lymphoplasmacytic inflammation (P = .035). A significant correlation was found between hypoalbuminemia and ileal lacteal dilatation (P = .033) and number of ileal intraepithelial lymphocytes (P = .019). A statistically significant correlation was found between hypocobalaminemia and number of ileal intraepithelial lymphocytes (P = .012).

Conclusions and Clinical Importance

When investigating dogs with chronic upper gastrointestinal signs, the collection of concurrent duodenal and ileal endoscopic biopsies is recommended.  相似文献   

3.
Modification of gastroduodenal motility has been proposed to aid endoscopic examination of the duodenum in dogs. The objective of this study was to evaluate the use of the following pharmacologic agents for facilitation of endoscopic intubation of the duodenum in 6 clinically normal dogs: metoclopramide HCl (0.2 mg/kg of body weight), atropine sulfate (0.045 mg/kg), glucagon (0.06 mg/kg), and isotonic saline solution. In a randomized, blinded, crossover design, the ease of endoscopic duodenal intubation was qualitatively scored by 3 endoscopists (in random order), using the following scale: 1 - immediate entry; 2 - rapid entry--moderate manipulation; 3 - difficult entry--multiple attempts; and 4 - no entry after 2 minutes [corrected]. Anesthesia was induced with thiopental and maintained with halothane. The 4 agents were diluted to a fixed volume and randomly administered. Duodenal intubation was attempted 2 minutes after IV injection of 1 of the agents. Four endoscopic procedures (1 for each agent) were performed on each dog with a minimum of 5 days between each procedure. In this study, no agent facilitated endoscopic duodenal intubation at the dose used. Instead, atropine and metoclopramide made duodenal intubation significantly more difficult, compared with use of saline solution. Difference between intubation after administration of glucagon and saline solution was not seen. On the basis of our findings, the use of these agents for facilitating endoscopic duodenal intubation is not recommended. In addition, in this study, we found that experience in endoscopic intubation is an important factor in determining the ease of duodenal intubation.  相似文献   

4.
Trefoil factors (TFF) are small peptides produced by goblet cells, which are crucial for epithelial restitution. In humans with inflammatory bowel disease (IBD), TFF expression is up-regulated as part of an unspecific repair mechanism. The goal of this study was to assess TFF gene expression in the gastrointestinal tract from dogs with IBD compared to healthy controls. Preliminary assessment by PCR revealed TFF1 and 3 expression in the small and large intestine, whereas TFF2 was amplified only in the stomach. Subsequent RT-qPCR (with relative quantification against 3 reference genes) on endoscopic duodenal (IBD n = 22, healthy controls n = 18) and colonic (IBD n = 12, controls n = 11) biopsies revealed that TFF1 expression was significantly up-regulated in the duodenum from IBD dogs (Mann–Whitney p = 0.001), whereas TFF3 expression was significantly lower in IBD colon compared to controls (t-test p = 0.018).This study demonstrates evidence for dysregulation of TFF gene expression in canine IBD. Up-regulation of TFF1 could signify ectopic expression as a compensatory repair-mechanism, whereas down-regulation of TFF3 could contribute to defective epithelial barrier function, respectively. Whether this is a cause or consequence of IBD could not be established.  相似文献   

5.
In order to assess an endoscopic collection procedure, populations of bacteria in duodenal fluid from seven adult cats were compared in paired samples obtained by endoscopy and direct needle aspiration during laparotomy. Each sample of duodenal juice was subjected to quantitative and qualitative culture of bacteria under both aerobic and anaerobic conditions. There were no significant differences in total numbers or individual species of bacteria comparing the two collection procedures. These findings indicate that collection of duodenal juice by endoscopy using the procedure described provides a representative sample of small bowel fluid for the assessment of the bacterial flora. Therefore, there appears to be no need for more invasive or complicated sampling techniques when quantitative and qualitative culture of duodenal juice is indicated as part of an investigation of small bowel disease in cats.  相似文献   

6.
The use of ultrasound to measure small bowel thickness is an important part of any ultrasound examination of the abdomen. Increased thickness of the intestinal wall is a hallmark for the detection of diseases ranging from inflammatory bowel disease to neoplasia. Our subjective impression has been that dogs with no clinical signs of gastrointestinal disease often have sonographic measurements greater than published norms. The purpose of this study was to prospectively reevaluate these norms. The clinical history on all dogs receiving an abdominal ultrasound examination was evaluated for signs of gastrointestinal disease. Those without clinical signs were entered into this study. The documentation of body weight, breed, jejunal thickness, and duodenal thickness was made in 231 dogs. Dogs were placed into five groups based on their weight. Sixty-nine breeds were represented with weight ranging from 2.1 to 64 kg. A statistically significant (P < or = 0.05) correlation between body weight and both jejunal and duodenal thickness was observed. We also found that the maximum thickness in both jejunum and duodenum in healthy dogs was larger than previously reported. These data indicate norms for the jejunum of < or = 4.1 mm for dogs up to 20 kg, < or = 4.4 mm for dogs between 20 and 39.9 kg, and < or = 4.7 mm for dogs over 40 kg. The data indicate norms for the duodenum < or = 5.1 mm for dogs up to 20 kg, < or = 5.3 kg for dogs between 20 and 29.9 kg, and < or = 6.0 mm for dogs over 30 kg.  相似文献   

7.
Idiopathic inflammatory bowel disease was the diagnosis for 58 dogs and 26 cats, with signs of persistent gastroenteritis, failed responses to dietary trials, and histologic evidence of cellular infiltrates unrelated to other causes of gastrointestinal tract inflammation. Clinical signs of large intestinal dysfunction, watery diarrhea, vomiting, and anorexia with weight loss were common. Nonspecific hematologic, biochemical, and radiographic abnormalities frequently were observed. Mucosal biopsy specimens, obtained endoscopically, were histologically evaluated for severity of mucosal epithelial damage. Mucosal erythema, friability, enhanced granularity, and ulceration or erosion were the predominant endoscopic lesions. Inflammatory bowel disease lesions of moderate severity predominated in the stomach, duodenum, and colon. Lymphocytic/plasmacytic infiltrates were limited to the lamina propria in biopsy specimens from all regions of the gastrointestinal tract. Inflammatory bowel disease commonly is associated with chronic gastroenteritis in dogs and cats.  相似文献   

8.
A grading system for lymphocytic plasmacytic colitis in dogs   总被引:1,自引:0,他引:1  
Colonic mucosal samples were obtained every 4 weeks for 13 months from 6 clinically normal dogs and from 47 dogs with a clinical diagnosis of chronic inflammatory bowel disease. All samples were graded on a scale of 0-5, based upon the quantity of lymphocytes and plasma cells in the lamina propria, epithelial changes, and the presence of ulcers and erosions. A grade of less than or equal to 2.0 was considered normal and was assigned to 77 of 78 samples from clinically normal dogs and 28 of 48 samples from dogs with diarrhea. A transient increase in cellularity was noted in 1 sample from 1 control dog. Nineteen dogs with clinical disease had obvious histologic abnormalities. The grading scheme described provides the pathologist with an objective criterion for the microscopic evaluation of colonic mucosal samples obtained by endoscopic techniques and offers clinicians a method of assessing the dog's progress and response to therapy.  相似文献   

9.
Objective-To determine whether lymphocyte apoptosis in intestinal mucosae is more common in healthy dogs than dogs with inflammatory bowel disease (IBD) and whether numbers of apoptotic cells increase after successful treatment of affected dogs. Animals-8 dogs with IBD (IBD dogs) and 8 healthy control dogs. Procedures-Biopsy specimens of the duodenum and colon were obtained via endoscopy from dogs with IBD before and after 10 weeks of standard treatment and compared with specimens obtained from control dogs. Expression of activated caspase 3 (Casp3), caspase-cleaved fragment p85 from poly-ADP-ribose polymerase (PARP), and B-cell leukemia/lymphoma 2 (Bcl-2) was measured in the duodenal (villous tip and base) and colonic mucosae. Results-Expression of Casp3 was greater in the duodenal villous tips of control dogs, compared with expression in similar tissues from dogs with IBD before or after treatment. Despite clinical improvement of dogs with IBD, expression of Casp3 did not increase after treatment. Expression of PARP did not differ between groups at any time point. Expression of Bcl-2 was greater at all 3 tissue sites in control dogs, compared with expression at the same sites in dogs with IBD. Furthermore, Bcl-2 expression in duodenal villous tips was higher in dogs with IBD after treatment but was not higher elsewhere. In control dogs, expression patterns for all 3 markers were similar between sites (villous tip > villous base > colon). Conclusions and Clinical Relevance-Expression of Casp3 in lymphocytes in duodenal villous tips was significantly reduced in dogs with IBD, compared with expression in healthy dogs, but no increase was detected following successful treatment of IBD. Increased expression of Bcl-2 may be a potential marker of the success of treatment.  相似文献   

10.
Intestinal wall thickness is neither a specific nor sensitive ultrasound parameter for detecting intestinal inflammation. We hypothesize that mucosal echogenicity, lymphadenomegaly, and secondary findings of the gastrointestinal tract would be more sensitive and specific markers for detecting and differentiating causes of chronic inflammatory bowel disease in dogs. Fifty-six client-owned dogs with chronic diarrhea and 10 control dogs were examined with two-dimensional, gray-scale ultrasound (time 0, 4, and 10 weeks post therapy) and small intestinal mucosal biopsies were performed at the 0- and 4-week time points. The clinical activity was assessed at each time point using the canine inflammatory bowel disease activity index (CIBDAI). Fifty-one dogs had inflammatory infiltration of the duodenal mucosa and were divided into three groups, food-responsive disease, idiopathic inflammatory bowel disease, and protein-losing enteropathy, based on their response to the different treatments and histology. Two different patterns of increased echogenicity of the mucosa were detected: hyperechoic speckles and hyperechoic striations. A normal, hypoechoic bowel mucosa in dogs with chronic diarrhea had a sensitivity of 80% and a specificity of 81% for the diagnosis of food-responsive disease. Hyperechoic striations had a sensitivity of 75% and a specificity of 96% for dogs with protein-losing enteropathy. Hyperechoic speckles were non-specific for diagnosing inflammatory bowel disease. There was a significant relationship between ultrasound score and CIBDAI at t0, but not following therapy. Mucosal echogenicity may be a better parameter for detecting inflammatory bowel disease than bowel wall thickness in dogs with chronic diarrhea.  相似文献   

11.
12.
Observations made during endoscopic evaluation of the stomach, duodenum, and colon of 58 dogs and 17 cats with a history of regurgitation, vomiting, and/or diarrhea were compared with results of histologic examination of tissues obtained during the procedures. Endoscopic observations included normal mucosa, alternations in mucosal color and texture, and luminal masses. Although endoscopy alone is a useful technique for detecting alterations of the gastrointestinal mucosa, histologic assessment of tissues obtained is necessary to confirm either an inflammatory or a neoplastic process.  相似文献   

13.
14.
15.
Repair processes of the inflamed intestine are very important for dissolution of chronic enteropathies (CE). Therefore, we examined the mRNA abundance of growth hormone receptor (GHR), insulin-like growth factors (IGF)-1 and -2 in duodenal and colonic biopsies of dogs with CE such as food-responsive diarrhoea (FRD) and inflammatory bowel disease (IBD) before and after treatment as compared with each other and healthy dogs. A clinical score (Canine IBD Activity Index = CIBDAI) was applied to judge the severity of CE. Biopsies of duodenum and colon from client-owned dogs with CE were sampled before (FRD(bef), n = 5; IBD(bef), n = 5) and after treatment (FRD(aft), n = 5; IBD(aft), n = 5). Intestinal control samples were available from a homogenous control population (n = 15; C). Intestinal samples were homogenized, total RNA was extracted, reverse transcribed and analysed by real-time polymerase chain reaction to measure mRNA levels of GHR, IGF-1 and IGF-2. Results were normalized with glyceraldehyde phosphate dehydrogenase as housekeeping gene. The CIBDAI decreased during the treatment period in FRD and IBD (P < 0.01). In duodenum, GHR mRNA levels were higher in all groups than in C (P < 0.001). Duodenal IGF-1 mRNA levels in FRD(aft) and IBD(aft) tended to be higher than in C (P < 0.1). The IGF-2 mRNA abundance in FRD(aft) was higher than in C (P < 0.05) in duodenum. In colon, mRNA levels of IGF-1 in IBD(aft) were higher than in FRD(aft) (P < 0.05) and levels differed between IBD(aft) and C (P < 0.05). In conclusion, mRNA levels of GHR, IGF-1 and IGF-2 in the gastrointestinal tract were increased during CE when compared with gastrointestinally healthy dogs. The data suggest that GHR, IGF-1 and IGF-2 are involved in gastrointestinal repair processes.  相似文献   

16.
Ultrasonographic intestinal muscularis thickening has not been described as an imaging feature of canine inflammatory bowel disease. In this retrospective case series, patients were identified by searching sonographic reports for “muscularis” and/or “muscular layer.” Patients were included if small intestinal muscularis thickening was reported, and sonographic images and histopathological samples of the small intestine were available for review. Cases with small intestines nodules, masses, or complete loss of wall layering were excluded. Sonographic images were retrospectively evaluated for jejunal muscularis layer thickness, and ratios of intestinal layer measurements were performed. Histological samples were retrospectively reviewed. Thirteen dogs met inclusion criteria: all dogs had sonographic intestinal muscularis thickening relative to the submucosa (>1.0, range of 1.3–2.5), and most dogs had muscular layer thickness above normal published ranges (11/13; all 13/13 above the weight-specific mean). More than half of the patients had overall normal wall thickness (11/13) and several had normal mucosal echogenicity (6/13). Therefore, in some dogs, the only sonographic abnormality in the small intestine was muscularis thickening. No dogs had lymphadenomegaly. Endoscopic partial-thickness (n = 11, duodenum and/or ileum) or surgical full-thickness (n = 2) samples confirmed inflammatory bowel disease. Direct comparison between jejunum sonographic characteristics and histology features was limited due to both partial thickness biopsies and lack of direct comparison between anatomical locations of ultrasonographic assessment and biopsy site. However, no cases that met the inclusion criteria had normal small intestinal histology. Comparable to cats, dogs with ultrasonographic intestinal muscularis thickening may have inflammatory bowel disease, and further workup for enteropathy is indicated.  相似文献   

17.
Distended lacteals, described as expanded white villi in duodenum, are strongly indicative of primary intestinal lymphangiectasia. In the present study, we evaluated the significance of white spots present in the duodenal mucosa of dogs with lymphocytic plasmacytic enteritis (LPE). Fifty dogs with LPE were included in this study, and white spots were detected in the duodenal mucosa in 22 dogs during endoscopy. Hypoproteinemia was more frequent in dogs with white spots than in dogs without spots (p = 0.02). Serum protein and albumin concentration were significantly lower in LPE dogs with white spots (p = 0.038) compared to LPE dogs without white spots (p = 0.039). There was a significant correlation between white spots density and lymphatic dilatation histological scores (p = 0.023; ρ = 0.481). These results suggest that the presence of white spots in the duodenal mucosa of dogs is not a finding exclusive for intestinal lymphangiectasia. Low serum protein and albumin concentrations together with lymphatic dilatation seem to be related to the presence of white spots in the duodenal mucosa of LPE dogs.  相似文献   

18.
Ultrastructure of the hydrophobic gastric surfactant barrier in the dog   总被引:1,自引:0,他引:1  
OBJECTIVES: To confirm the hydrophobicity of the luminal surface of the canine stomach and to elucidate the ultrastructure of the lining imparting that property. DESIGN AND PROCEDURES: Gastric and duodenal mucosal samples from eight dogs were collected immediately after euthanasia and subjected to contact angle measurement using a goniometer. Other samples were examined by electron microscopy following a fixation procedure known to preserve phospholipids and oligolamellar structures. RESULTS: Contact angles for the canine gastric mucosal surface (85.1 +/- 5.5) were significantly greater (P < 0.0001) than for the duodenum (24.0 +/- 1.7). Electron microscopy revealed the existence of surfactant as abundant osmiophilic phospholipid material within the gastric and duodenal mucosae. CONCLUSION: We have confirmed the hydrophobic nature of the canine gastric mucosa whereas the luminal surface of the duodenum is hydrophilic. We propose that the water-repellent nature of the canine gastric lining contributes to the 'gastric mucosal barrier' and is imparted by an oligolamellar layer of surface-active phospholipid ('gastric surfactant') adsorbed to the surface. Both gastric and duodenal mucosae may also utilise phospholipids as an intercellular defense mechanism in the event that tight junctions are breached by acid. It is tempting to speculate that a deficiency of gastric phospholipids may predispose dogs to ulcers. Further, exogenous administration of phospholipids may be useful in preventing gastric ulceration.  相似文献   

19.
20.
Upper GI endoscopy is a frequently performed endoscopic procedure that is particularly suited for the diagnosis of upper GI diseases with a luminal or mucosal location. Contraindications are few and complications are rare. Procedures that can be performed during upper GI endoscopy include mucosal biopsy, brush cytology, aspiration of duodenal fluid for culture and cytology, foreign body retrieval, bougienage of strictures, and endoscopic placement of gastrostomy tubes. Unresolved issues that face veterinary endoscopists include the interrelationship between contrast radiology and endoscopy, the advisability of routine combination of upper and lower GI endoscopy, the reasons for discordance among clinical signs, endoscopic appearance, and biopsy findings, and the role of post-treatment biopsies.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号