A 14-year-old MN DSH was presented for evaluation of decreased appetite and icterus and had shown some response to symptomatic therapy – IV fluids, Cerenia, famotidine, vitamin K, orbifloxacin, and an appetite stimulant. Abnormalities on serum biochemistry were elevated ALP activity and bilirubin (22).
Chronic cholecystitis and mucocele formation with thickened common bile duct.
Heterogenous pancreatic changes with dilated pancreatic duct.
The liver revealed increased portal markings along with coarse architecture. The liver revealed irregular contour. The gallbladder was thickened and irregular with suspended debris. This is consistent with mucocele formation. The common bile duct was thickened in this patient with echogenic debris or tissue proliferation in the last 2.0 cm in the common bile duct. Heterogenous pancreatic changes were noted with reactive surrounding mesentery. The pancreatic duct was also dilated, thickened and irregular owing to post hepatic obstruction and CBD thickening at the duodenal papilla. The muscularis layer of the jejunum was hypertrophied inverting the normal ratio (1:3).
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Liver – toxins, abscessation, cholangio-hepatitis complex, lipidosis, neoplasia, FIP
Gall bladder – cholecystitis, obstruction (lith, neoplasia, pancreatic/duodenal disease)
Pancreas – pancreatitis, neoplasia
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