A 9-year-old intact male Sheltie that had recently been rescued was presented for evaluation of a perianal hernia. Abnormalities on CBC and serum biochemistry were neutrophilia and elevated ALT (126), ALP (638) and GGT (21) activity.
Case Study
Ruptured mucocele with bile peritonitis in a 9 year old M Shetland Sheepdog
DX
Ruptured gallbladder mucocele with focal bile peritonitis
Sonographic Differential Diagnosis
Ruptured gallbladder mucocele with focal bile peritonitis adhesions.
Image Interpretation
The gallbladder in this patient was completely disrupted with evidence of rupture and adhesions. Coalesced bile and blood clot type echogenicities were noted as well as fatty inflammation and adhesion pattern all around the gallbladder occupying the left and right medial liver. The liver itself was coarse and mildly irregular, yet the gallbladder appears to be the primary issue. No overt evidence of neoplasia. The common bile duct does not appear to be overtly affected, yet should be flushed at the time of surgery.
Clinical Differential Diagnosis
Liver – nodular regeneration, reactive hepatopathy, vacuolar hepatopathy, inflammatory hepatopathy, neoplasia
Gall bladder – cholecystitis, mucocele
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Patient Information
Patient Name :
Max
Gender :
Male, Intact
Species :
Canine
Type of Imaging : Ultrasound
Status :
Complete
Liz Wuz Here :
Yes
Code :
03_00544
Images
Blood Chemistry
- Alkaline Phosphatase (SAP), High
- ALT (SGPT), High
- GGT High
CBC
- WBC, High