Hello
This is an 11 year old cat that presented with sudden onset of lethargy and innappetence. Liver enzymes were elevated, spec lipase was elevated and cat was mildly to moderately jaundiced. Stomach was filled with fluid.
Hello
This is an 11 year old cat that presented with sudden onset of lethargy and innappetence. Liver enzymes were elevated, spec lipase was elevated and cat was mildly to moderately jaundiced. Stomach was filled with fluid.
Gall bladder was full and distended and the bile ducts were tortuous. I believe I can measure the common bile duct at 0.5cm and I believe I see a hyperechoic mass/obstruction near the duodenal papilla. I performed a search and found similar images to support this. I was hoping to have some confirmation on what I am seeing. I believe it most likely to be a stone. I also believe I see some hypoechoic focal areas within the pancreas that are visible at this level. The cat was unfortunately euthanized prior to treatment being initiated. Thanks. Brent.
Comments
Great image set Brent! The
Great image set Brent! The panc duct and cbd are dilated and the polypoid structure (long arrow) is of concern and there is a small stone (small arrow). So the sudden onset makes me think he was potentially popping stones through the cbd and the polyp is secondary proliferative and hyperplastic… cbd carcinoma looks like this but usually more extensive. Needed sx because the cbd is > 5 mm and he is clinical… Lavage and redirect the cbd would be the way to go. You can put power doppler on these polyp as well to ensure its tissue and not a gelling bile plug but it looks like tissue. Bile duct carcinoma is more indidious and progressive typically where sudden onset is more stone obstruction and infaction btu not always. Let us know if you get a post mortem on this poor guy.
Great image set Brent! The
Great image set Brent! The panc duct and cbd are dilated and the polypoid structure (long arrow) is of concern and there is a small stone (small arrow). So the sudden onset makes me think he was potentially popping stones through the cbd and the polyp is secondary proliferative and hyperplastic… cbd carcinoma looks like this but usually more extensive. Needed sx because the cbd is > 5 mm and he is clinical… Lavage and redirect the cbd would be the way to go. You can put power doppler on these polyp as well to ensure its tissue and not a gelling bile plug but it looks like tissue. Bile duct carcinoma is more indidious and progressive typically where sudden onset is more stone obstruction and infaction btu not always. Let us know if you get a post mortem on this poor guy.