Common bile duct obstruction

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Common bile duct obstruction

Hi everyone, 

– I have a case of a 10 year old male entire Cocker Spaniel presented unwell, pyrexic, jaundiced, was also dyschezic with painful prostate. 

– Bloods: neutrophilic leucocytosis, moderate to markedly elevated liver enzymes and bilirubin (105).

Hi everyone, 

– I have a case of a 10 year old male entire Cocker Spaniel presented unwell, pyrexic, jaundiced, was also dyschezic with painful prostate. 

– Bloods: neutrophilic leucocytosis, moderate to markedly elevated liver enzymes and bilirubin (105).

– Ultrasound showed dilation of the common bile duct with a soft tissue stucture at the duodenal papilla. I thought this was a mass but when I went to aspirate it, the structure moved within the duct as if it was a mobile mucus plug. What is your impression of this structure please? Can I rule out a mass?

– The gallbladder had an irregular lining and mucoid polyp like mass.

– There was another hypoechoic structure within the liver adjacent to the gallbladder, is this lobar duct dilation? or a cystic mass?

– How would you remove the structure causing bile duct dilation?

Many thanks in advance. 

Comments

randyhermandvm

To me this looks like a mass.

To me this looks like a mass. Compressing the duodenum.

Needs exploratory surgery.

randyhermandvm

To me this looks like a mass.

To me this looks like a mass. Compressing the duodenum.

Needs exploratory surgery.

EL

1 cm cbd/d-pap mass wiht post

1 cm cbd/d-pap mass wiht post hepatic obstruction needs cholecystoduoidenostomy… carcinoma vs inflammatory polyp… had one of these that was duodenal lymphoma but took up more intestinal wall.

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