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03_00334 Taylor R Posthepatic obstruction

Case Study

03_00334 Taylor R Posthepatic obstruction

A 14-year-old SF DSH was presented for evaluation of weight loss and vomiting. Abnormalities on CBC ands serum biochemistry were leukocytosis and elevated liver enzyme activity.

A 14-year-old SF DSH was presented for evaluation of weight loss and vomiting. Abnormalities on CBC ands serum biochemistry were leukocytosis and elevated liver enzyme activity.

Sonographic Differential Diagnosis

Post hepatic obstruction owing to calculi.
Common bile duct and cystic duct calculi and pancreatic duct calculi.
Recommend surgical intervention with bile duct deviation along with hepatic, pancreatic and gastrointestinal biopsies. Guarded prognosis. It is felt that the calculi presentation are too large to attempt medical therapy and surgical intervention is essential.

Image Interpretation

The liver in this patient presented multiple lobar biliary calculi. The gallbladder also revealed embedded calculi. The common bile duct was dilated at 0.43 cm with an embedded calculus that measured 0.74cm. Adjacent to the calculus in the distal CBD, there is a calculus dilating the pancreatic duct.

DX

Post hepatic bile duct obstruction

Outcome

None

Clinical Differential Diagnosis

Liver – cholangio-hepatitis complex, neoplasia, granulomatous disease, abscessation
Gall bladder – cholecystitis, neoplasia, liths
Pancreas – pancreatitis, neoplasia

Sampling

None

Video

Patient Information

Gender : Female, Spayed
Species : Feline
Type of Imaging : Ultrasound
Status : Complete

Clinical Signs

  • Vomiting
  • Weight loss

Images

liver_lithslarger_cbd_stone_meascbd_measpanc_duct_stone_meas

Blood Chemistry

  • Elevated Liver Enzymes

CBC

  • WBC, High

Clinical Signs

  • Vomiting
  • Weight loss