03_00436 Koko C Ruptured mucocele

Case Study

03_00436 Koko C Ruptured mucocele

An 8-year-old SF Poodle was presented for evaluation of anorexia, polydipsia, and vomiting. Abnormalities on serum biochemistry were elevated ALT (700), ALP (> 2000), and GGT (52) activity and total bilirubin (4.7).

An 8-year-old SF Poodle was presented for evaluation of anorexia, polydipsia, and vomiting. Abnormalities on serum biochemistry were elevated ALT (700), ALP (> 2000), and GGT (52) activity and total bilirubin (4.7).

Sonographic Differential Diagnosis

Severe rupture. Gallbladder mucocele, bile peritonitis. Regional, minor pancreatitis. Age related renal changes. This is a surgical emergency. Coagulation panel, plasma transfusion and broad-spectrum antibiotics as well as immediate surgical intervention for bile peritonitis would be recommended.

Image Interpretation

The liver images from right and left intercostal as well as subcostal views revealed subjectively normal liver size, 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 common bile duct was moderately dilated with an echogenic wall and echogenic debris. The width measured 0.77 cm. The common bile duct presented echogenic debris throughout its length. The gallbladder was completely disrupted in architecture with rupture and regional inflammatory pattern. This is consistent with perforated gallbladder mucocele.

DX

Ruptured mucocele

Outcome

None

Clinical Differential Diagnosis

Liver – acute hepatitis (viral, bacterial, fungal, toxins), trauma, neoplasia, abscessation
Gall bladder – cholecystitis, mucocele
Pancreas – acute pancreatitis

Sampling

None

Patient Information

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

Clinical Signs

  • Anorexia
  • Polydipsia
  • Vomiting

Images

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Blood Chemistry

  • Alkaline Phosphatase (SAP), High
  • ALT (SGPT), High
  • GGT High
  • Total Bilirubin, High

Clinical Signs

  • Anorexia
  • Polydipsia
  • Vomiting
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