ALT 500s sap 600s and Bili of 12.5 in a 10 year old yellow cat fresh of my telemedicine lineup today. Pancreatitis, minor lobar biliary dilation and this structure located in the proximal cbd or is it a LN overlying it?? What do you think? Is this a biliary post hepatic obstruction or is this a LN linked to hepatic parenchymal disease? What would you do next?
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I don’t think I can tell for
I don’t think I can tell for sure? Perhaps try colour Doppler and look for a LN pattern? If FNA sampling gives no clues then surgical explore. The common bile duct does not look huge?
CT may help here – if only we all had one. In my world further diagnostics are often declined here so steroids/liver support and a feeding tube then rescan