This 12 year old FS Chihuahua had vomited 10 times since the previous afternoon. History of IBD diagnosed with biopsy; history of pancreatitis
Chem: amylase 2500, lipase 1000, glucose 133, total bili 1.4, GGT 22
This 12 year old FS Chihuahua had vomited 10 times since the previous afternoon. History of IBD diagnosed with biopsy; history of pancreatitis
Chem: amylase 2500, lipase 1000, glucose 133, total bili 1.4, GGT 22
The left adrenal gland was slightly swollen and measured 0.75 cm at the caudal pole, 0.48 cm at the cranial pole and 1.76 cm in length. The right adrenal gland was mildly irregular rand measured 1.74 x 0.68 cm at the caudal pole and 0.57 cm at the cranial pole. The liver was uniformly enlarged. Deviation of the pyloric outflow was noted with a mass effect. The duodenum presented hypertrophy of the muscularis. Focal areas of mineralization were noted. Regional inflammation was noted. The pancreas in this patient was enlarged, primarily in the right limb with mixed, hypoechoic irregular changes and pericapsular inflammatory pattern. Nodular changes or micro abscessation was noted in the right limb. The extension of pathology of the right pancreatic limb measured 4.37 x 4.0 cm.
R/O pancreatitis vs pancreatic carcinoma; possible adrenal adenoma or hyperplasia with minor potential for neoplasia. Recommend FNA of pancreas and liver, and blood pressure measurements.
The pancreatic pathology envelops the area of the common bile duct.
Post hepatic obstruction is likely the cause of bilirubin elevation if the bilirubin elevation is not
artifactual. Recheck of the bilirubin values would be recommended. Ultrasound-guided
FNA is strongly recommended to rule out carcinoma versus pancreatitis/pancreatic
necrosis. Aggressive treatment for pancreatitis is recommended in the meantime.
Followup ultrasound 3 weeks later: The pancreas was significantly improved and mildly enlarged measuring 1.4 cm. The pancreatic presentation is essentially resolved. There was no significant residual inflammation noted
