Hello
I was just hoping for some input on these images. We have a 10year old FS DSH that is yellow as a banana.
The bile ducts are tortuous and hypoechoic but there also appears to be stones within the biliary tract within the liver.
Hello
I was just hoping for some input on these images. We have a 10year old FS DSH that is yellow as a banana.
The bile ducts are tortuous and hypoechoic but there also appears to be stones within the biliary tract within the liver.
I have not seen this previously. The larger stone has shadowing in the far field therefore I do not believe it to be a mass and on the video clips there appears to be a branching pattern of bile ducts with consolodiated hyperechoic sludge. The GB does not appear perfectly normal but no obvious stones. Is this a typical pattern that can be seen with bile duct obstruction?
Thanks. Brent
Comments
All those echogenic
All those echogenic structures are stones in the lobar ducts, the GB (long red arrow) and the cbd (red line shows the cbd diameter) and the cbd is dilated to about 0.8 cm+/-… > 0.4 cm is a surgical cbd when clinical signs are present. Putting color flow over the portal hilus will differentiate the portal vein (color +) from the cbd (color -) So this cat needs cholecystoduodenostomy likely or at least cbd labvage and stone removal with liver bx. See attached screen shot of your video. The screen arrow points to th ecbd wiht an echogenic stone in it. Bile stones dont shadow like urinary stones as the echoes get absorbed in the liver parenchyma and bile as opposed to the fast traveling echoes in the urine with bladder stones that cast an acoustic shadow more readily. Off to sx:)
Check out these cbd obstruction cases from the basic search:
http://sonopath.com/members/case-studies/search?text=cbd+obstruction&species=All
Nice post!
All those echogenic
All those echogenic structures are stones in the lobar ducts, the GB (long red arrow) and the cbd (red line shows the cbd diameter) and the cbd is dilated to about 0.8 cm+/-… > 0.4 cm is a surgical cbd when clinical signs are present. Putting color flow over the portal hilus will differentiate the portal vein (color +) from the cbd (color -) So this cat needs cholecystoduodenostomy likely or at least cbd labvage and stone removal with liver bx. See attached screen shot of your video. The screen arrow points to th ecbd wiht an echogenic stone in it. Bile stones dont shadow like urinary stones as the echoes get absorbed in the liver parenchyma and bile as opposed to the fast traveling echoes in the urine with bladder stones that cast an acoustic shadow more readily. Off to sx:)
Check out these cbd obstruction cases from the basic search:
http://sonopath.com/members/case-studies/search?text=cbd+obstruction&species=All
Nice post!