A 6-year-old NM Ferret was presented for evaluation of anorexia and icterus. Abnormalities on CBC and serum biochemistry were severely elevated ALT activity, elevated bilirubin, and hypoalbuminemia.
Case Study
03_00527 Pablo W Mass at duodenal papilla
Sonographic Differential Diagnosis
Post hepatic obstruction with tissue nodule at the common bile duct. Suspect bile duct carcinoma, potential isoechoic metastatic disease. Localized free fluid, potential paraneoplastic versus portal hypertension.
Image Interpretation
The liver presented lobar duct dilation. An isoechoic to slightly hyperechoic nodule was noted in the deep right liver. This may represent a metastatic lesion. Gallbladder distension and tortuous cystic duct were noted. The common bile duct was severely dilated at 0.75 cm. The common bile duct was followed to the duodenal papilla and a 1.0 cm mixed, echogenic tissue structure with focal mineralization was noted. A minor amount of free fluid was noted in the abdomen.
DX
Mass at duodenal papilla
Outcome
None
Clinical Differential Diagnosis
Liver – acute hepatitis (viral, bacterial, toxins), neoplasia
Gall bladder – cholecystitis, obstruction (lith, neoplasia, duodenal/pancreatic disease)
Sampling
None
Video
Patient Information
Gender :
Male, Neutered
Species :
Exotic
Type of Imaging : Ultrasound
Status :
Complete
Clinical Signs
- Anorexia
- Icterus
Images
Blood Chemistry
- Albumin, Low
- ALT (SGPT), High
- Total Bilirubin, High
Clinical Signs
- Anorexia
- Icterus