Efusão biliar pleural em um gato: Relato de cas

Abstract

Pleural biliary effusion is a disease of hard diagnosis in cats with very few descriptions in the literature. A cat came in to receive medical care with intense vocalization, abdominal pain, mydriasis, anorexia, oligodipsia, reddish urine, and dyspnea. Imaging examinations resulted in radiopaque amorphous diffuse material through the chest cavity and observation of structure consistent with abdominal contents into the chest cavity. A sample of pleural fluid was collected and the analysis showed characteristics of the total protein and total concentration of nucleated cells consistent with modified transudate, but cytological examination of the sample resulted in the observation of specific findings that led to think of biliary effusion. The effusive concentration of bilirubin of this sample was 32.4 mg/dL and its relation to serum concentration was equal to 27.0. The examination was concluded as a modified transudate associated with biliary effusion. Complete blood counts of the same date resulted in leukopenia and neutropenia with a left shift, lymphopenia and decreased concentration of platelets. The animal underwent a surgical procedure, which was evidenced diaphragmatic hernia with translocation of liver and gallbladder into the chest cavity and rupture of the gallbladder and intestine. A sample of peritoneal fluid was sent for analysis and revealed characteristics consistent with septic exudate associated with biliary effusion such as prevalence greater than 90% of degenerated neutrophils phagocytosed bacteria and effusive bilirubin concentration = 42.1 mg / dL. The diagnosis of this condition can be accomplished through a set of laboratory and imaging tests. The measurement of bilirubin concentrations, specially effusive, is the key to complete the diagnosis and many parameters must be used, sometimes subjectively, to suspect this disease