- 4 year old DSH presented for vomiting and possible plastic bag ingestion.
- Chemistry profile showed an ALT>1000 and Total bilirubin=3.8.
- Abdominal ultrasound shows dilated intrahepatic bile ducts, turgid gallbladder with a thickened wall, dilated and tortuous cystic duct, and a 2.5cm hypoechoic mass obstructing the extrahepatic biliary tract. No GI foreign bodies are seen. Urinary bladder calculi are present.
- 4 year old DSH presented for vomiting and possible plastic bag ingestion.
- Chemistry profile showed an ALT>1000 and Total bilirubin=3.8.
- Abdominal ultrasound shows dilated intrahepatic bile ducts, turgid gallbladder with a thickened wall, dilated and tortuous cystic duct, and a 2.5cm hypoechoic mass obstructing the extrahepatic biliary tract. No GI foreign bodies are seen. Urinary bladder calculi are present.
- My primary differential diagnosis for this cat was intially pancreatitis due to the patient’s age. However, upon review, in some clips the mass appears intraluminal (in the bile duct). My complete differential diagnoses list includes pancreatitis, pancreatic neoplasia, bile duct neoplasia (carcinoma) and possibly intraluminal sludge.
- I recommended referral for exploratory surgery with possilbe cholecystectomy or cholecystoduodenostomy.
- Any other thoughts on the pathology of this mass?
