Sonographische Befunde bei ausgewählten gastrointestinalen Erkrankungen von Hund und Katze

Zusammenfassung

Gegenstand und Ziel: Zur Abklärung von Magen-Darm-Erkrankungen können unter anderem eine Sonographie und Endoskopie notwendig sein. Ziel der Studie war, mögliche Zusammenhänge zwischen Sonographiebefunden und folgenden Erkrankungen des Magen-Darm-Trakts aufzuzeigen: IBD (Inflammatory Bowel Disease), FRD (Food Responsive Diarrhoea), Ulzera und Infektion mit GHLO (Gastric Helicobacter-Like Organisms). Material und Methoden: Es erfolgte eine retrospektive Auswertung der Daten von 41 Hunden und 19 Katzen. Kriterien zur Aufnahme in die Studie waren akute oder chronische Magen-Darm-Symptome und der Ausschluss extragastrointestinaler Erkrankungen. Die weitere Abklärung bestand aus einer Sonographie und Endoskopie des Magen-Darm-Trakts sowie der histologischen Untersuchung von Gewebeproben. Ausgeschlossen blieben Tiere mit intestinalen Fremdkörpern, Neoplasien des Magen-Darm-Trakts und nicht klassifizierbaren Histologiebefunden. Ergebnisse: Bei 16 der 41 Hunde konnte eine IBD, bei 14 eine FRD, bei 5 Ulzera und bei 6 eine Infektion mit GHLO nachgewiesen werden. Bei 12 der 19 Katzen wurde eine IBD, bei 2 eine FRD, bei 2 Ulzera und bei 3 eine Infektion mit GHLO diagnostiziert. Im Fall von 26 Hunden und 4 Katzen ließen sich trotz klinischer Symptomatik und spezifischen Histopathologiebefunden keine sonographischen Veränderungen des Magen-Darm-Trakts feststellen. 14 Hunde und 4 Katzen zeigten teils multiple Befunde an extragastrointestinalen Organen. Bei den Katzen mit IBD waren oft Lymphadenopathien (4 Katzen) und eine verdickte Zona muscularis (6 Katzen) darstellbar. Weder bei der FRD noch einer Infektion mit GHLO ergaben sich spezifische Sonographiebefunde. Eine Infektion mit GHLO ließ sich bei nur 5 Hunden und 1 Katze, die nicht primär daran erkrankt waren, nachweisen. Ein Hinweis auf das Vorliegen eines Ulkus fand sich sonographisch in Form eines gasberandeten Areals mit Substanzverlust. Schlussfolgerung und klinische Relevanz: Sonographisch lassen sich bei einer IBD und einer Ulkuserkrankung Veränderungen finden. Ein unauffälliger Sonographiebefund schließt eine schwerwiegende Magen-Darm-Erkrankung nicht aus. Die histopathologische Untersuchung stellt weiterhin einen wichtige Baustein bei der Diagnosestellung der untersuchten Erkrankungen dar.

Summary

Objective: In addition to general and specific examinations, ultrasonographic and endoscopic examinations of the gastrointestinal tract may be necessary. This study aimed to determine possible relationships between the ultrasonographic and histopathological findings in the following diseases of the gastrointestinal tract: IBD (inflammatory bowel disease), FRD (food-responsive diarrhoea), ulcer and infection with GHLO (gastric Helicobacter-like organisms). Material and methods: The data of 41 dogs and 19 cats were analysed. The inclusion criterion was the presence of acute or chronic gastrointestinal symptoms in patients that had also undergone the standard diagnostic tests to rule out extragastrointestinal diseases. The patients underwent ultrasonographic and endoscopic examinations of the gastrointestinal tract, and a histopathological examination of the tissue samples from the endoscopy was performed. Patients with intestinal foreign bodies, neoplasms of the gastrointestinal tract or inconclusive histopathological results were excluded. Results: In a total of 41 dogs, 16 were diagnosed with IBD, 14 with FRD, 5 with ulceration and six with an infection with GHLO. Of the 19 cats, 12 had a diagnosis of IBD, 2 of FRD, 2 with ulceration and 3 with an infection with GHLO. In 26 dogs and 4 cats of the evaluated patients, the ultrasonographic examination did not show pathological changes, even though the patients had clinical symptoms and significant histopathological findings. However, in 14 dogs and 4 cats of the included patients, one or more pathological changes of the extragastrointestinal organs were found. In particular, cats with a diagnosis of IBD often presented lymphadenopathies (4 cats) or thickening of the zona muscularis (six cats). There were no specific ultrasonographic findings confirming an FRD or an infection with GHLO. Only 5 dogs and 1 cat without a primary diagnosis of infection with GHLO were positive for colonization with GHLO. The presence of ulcers was ultrasonographically indicated as areas showing a loss of wall layering with accumulation of gas. Conclusion and clinical relevance: Changes can be found during ultrasonographic examinations of patients with IBD and ulcer. However, the absence of findings in ultrasonographic examinations does not necessarily rule out serious gastrointestinal diseases. The histopathological examination still plays an important part in diagnosing the evaluated diseases.

Schlüsselwörter

Inflammatory Bowel Disease - Food Responsive Diarrhoea - gastrointestinales Ulkus - Gastric Helicobacter-Like Organisms

Key words

Inflammatory bowel disease - food responsive diarrhoea - gastrointestinal ulcer - gastric Helicobacter-like organisms

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