A 14-year-old SF DSH was presented for evaluation of weight loss, anorexia, vomiting, and icterus. Abnormalities on serum biochemistry were elevated ALT (1056), amylase (1574), and bilirubin (7.6).
A 14-year-old SF DSH was presented for evaluation of weight loss, anorexia, vomiting, and icterus. Abnormalities on serum biochemistry were elevated ALT (1056), amylase (1574), and bilirubin (7.6).
Post hepatic obstruction owing to 1.0 cm tissue thickening/mass at the distal portion of the common bile duct/duodenal papilla. Inflammatory lesion is possible.
The liver presented lobar biliary duct dilation with an overt 1.0 cm tissue proliferation at the common bile duct juncture with the duodenal papilla. This created a mass type effect. Slightly hyperechoic nodules were noted in the liver parenchyma, which may represent metastatic disease. Lobar duct dilation was noted throughout the liver. This is indicative of post hepatic obstruction. The gallbladder was mildly over distended. The cystic and common bile ducts were normal. Regional inflammatory pattern was noted around the common bile duct. No pathological hepatic lymphadenopathy was evident. No overt structural evidence of inflammatory, infiltrative or regenerative pathology was noted.
I recommend exploratory surgery with potential for metastatic disease. Guarded prognosis
Hemolytic disease – hemoplasmosis, IMHA
Liver – cholangio-hepatitis, FIP, neoplasia, granulomatous disease, toxins
Gall bladder – cholecystitis, neoplasia, obstruction (lith, duodenal/pancreatic disease)
Pancreas – pancreatitis, neoplasia
