Hello
This is Bentley a 4 year old Beagle who presented for a painful abdomen 1 week ago. Xrays and US were consistent with pancreatitis and the gallbladder images were consistent with a mucocoele. there was free fluid in the abdomen.
The free fluid was suppurative and septic. The pancreas FNA revealed normal pancreatic cells.Owners were at the upper limit of their finances so we treated as an outpatient. Pathologist indicated that rarely is there bacteria with pancreatitis so she was thinking GI origin like a foreign body purf.
Hello
This is Bentley a 4 year old Beagle who presented for a painful abdomen 1 week ago. Xrays and US were consistent with pancreatitis and the gallbladder images were consistent with a mucocoele. there was free fluid in the abdomen.
The free fluid was suppurative and septic. The pancreas FNA revealed normal pancreatic cells.Owners were at the upper limit of their finances so we treated as an outpatient. Pathologist indicated that rarely is there bacteria with pancreatitis so she was thinking GI origin like a foreign body purf.
1 week later he has come in and is clinically doing better. Repeat US shows the pancreas is still markedly inflammed but instead of being hypoechoic it is now more hyperechoic and I have a question whether one portion bordering the stomach is abcessed? The FF fluid has decreased by 1/2 in my opinion; only visible near the spleen.
The gall bladder looks roughly the same. I reviewed the protocols on this website for measuring the GB. The pathologist indicates that the majority of GB mucoceoles are chronic and can be managed medically unless there is iniment danger of rupture.
I also found a hypoechoic/anechoic circular area between the spleen and Lt kidney that I initially thought was the Rt lobe of the pancreas but cannot connect the two. Could this be an abcess from a fb that the pathologist was commenting on?
Clients have now found some more financing and are considering an exploratory and possibly cholycystectomy. Wise decision?
Thanks. Looking for some guidance on how to manage this case. Brent
Comments
Here is the “Abcess” between
Here is the “Abcess” between the spleen and the Lt kidney
***FYI please keept o short
***FYI please keept o short bullet forum format on descriptions Thx
Your first image /video shows a pancreatic necrosis with microabscessation so that will take time to resolve fluids fluids fluids and maybe surgical debridement. Your second video says pancreas but looks like a Gb in midst of liver wiht suspended bile and mildly echogenic wall.
Your this image is either panc necrosis or if spleen then splenitis, splenic torsion or neoplasia… tough to tell o a still. Lots going on here.
Thanks. All that makes
Thanks. All that makes perfect sense.
What is your thought on septic fluid in the abdomen from pancreatic necrosis. Likely not common? Thanks