Ruptured gallbladder mucocele with bile peritonitis in an 8 year old FS Sheltie

Case Study

Ruptured gallbladder mucocele with bile peritonitis in an 8 year old FS Sheltie

An 8-year-old SF Sheltie was presented for evaluation of vomiting and diarrhea over a 1-2 week period and recent onset acute abdomen.

Medications: metronidazole 250mg BID, clavamox 125mg BID

Radiograph Findings: no obvious obstructive pattern but, material in stomach.

An 8-year-old SF Sheltie was presented for evaluation of vomiting and diarrhea over a 1-2 week period and recent onset acute abdomen.

Medications: metronidazole 250mg BID, clavamox 125mg BID

Radiograph Findings: no obvious obstructive pattern but, material in stomach.

DX

Ruptured gallbladder mucocele with bile peritonitis

Image Interpretation

Sonographic Interpretation: The liver images from right and left intercostal as well as subcostal views revealed subjectively normal liversize, contour, and structure. Parenchymal echogenicity was naturally coarse and hypoechoic to the spleen. Vascular and biliary tracts were of normal volume and no evidence of congestion was noted. The gallbladder was severely dilated at 5.0 cm with an ill defined wall, regional inflammation and localized free fluid. This is consistent with ruptured gallbladder mucocele. Immediate supportive care and staging for surgery is recommended. Partial collapse was noted owing to leakage. Regional peritonitis was noted throughout the cranial abdomen. The common bile duct was enveloped by reactive surrounding and therefore could not be evaluated. However, it should be flushed at the time of surgery.

Outcome

Plasma transfusion, coagulation panel, Vitamin K supplementation and immediate surgical intervention was recommended. Very guarded prognosis.

Clinical Differential Diagnosis

GIT – foreign body with perforation, ulceration, neoplasia
Pancreas – pancreatitis, neoplasia, abscessation
Gall bladder – cholecystitis, rupture
Liver – abscessation
Peritonitis – bacterial, urine, bile

Patient Information

Patient Name : Callie Hardwick
Gender : Female, Spayed
Species : Canine
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 03_00565

Clinical Signs

  • Abdominal Pain
  • Diarrhea
  • Vomiting

Exam Finding

  • Abdominal Pain

Images

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Clinical Signs

  • Abdominal Pain
  • Diarrhea
  • Vomiting
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