Imaging Diagnosis—extrahepatic Biliary Tract Obstruction Secondary to a Biliary Foreign Body in a Cat

Brioschi, Valentina; Rousset, Nicolas; Ladlow, Jane

doi:10.1111/vru.12081

Cited by 19 publications

(23 citation statements)

References 21 publications

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“…Therefore, zone 3 is more susceptible to hypoxia, while zone 1 is more likely to suffer direct toxic damage Extrahepatic bile duct obstruction Aetiology Bile sludge and choleliths, associated with cholangitis, cholecystitis and impaired contractility of the gallbladder, have been implicated as the most common causes of extra hepatic bile duct obstruction (EHBDo). [21][22][23] other causes include pancreatitis, 12,22 biliary neoplasia, 22 foreign bodies, 21,24 biliary mucoceles 18 and gastrointestinal disease. 23…”

Section: Cholestasismentioning

confidence: 99%

Feline biliary tree and gallbladder disease: Aetiology, diagnosis and treatment

Otte

Penning

Rothuizen

2017

Journal of Feline Medicine and Surgery

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Practical relevance Diseases of the biliary tree and gallbladder are more common in cats than diseases of the liver parenchyma. The parenchyma is usually affected secondarily to systemic illnesses, while the biliary system is the prime target for infectious agents (eg, bacteria and flukes) and non-infectious conditions (eg, neoplasia and cysts). Clinical approaches Cats with biliary disease are evaluated because of common feline clinical signs such as anorexia, nausea, vomiting and lethargy. Icterus may or may not be obvious. Biopsies for histological evaluation, and bile aspirates for culture and cytological evaluation are helpful diagnostically. Antibiotics and immunosuppressive drugs have been used successfully. Hepatosupportive drugs may help in liquefying thick bile and protecting hepatic tissue from damage. Ultrasound is a noninvasive diagnostic tool that may help in identifying dilated bile ducts, liver cysts and choleliths. It is also used to guide percutaneous bile aspiration. Audience This review, written for all veterinarians who treat cats, describes the various conditions that can affect the feline biliary tree and gallbladder. Treatment options are discussed, and brief summaries provided of surgical techniques and diagnostic approaches. Evidence base The veterinary literature pertaining to feline biliary disease is comprehensively reviewed. When appropriate, data on dogs and humans has been included to provide background information. Based on the available literature, more research into feline biliary diseases is needed.

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Section: Cholestasismentioning

confidence: 99%

Feline biliary tree and gallbladder disease: Aetiology, diagnosis and treatment

Otte

Penning

Rothuizen

2017

Journal of Feline Medicine and Surgery

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“…Unusual causes of EHBO reported in cats have included the presence of grass awns within the CBD, a foam earplug in the duodenum at the level of the major duodenal papilla, constriction of the CBD by cat hair as a result of involuntary transcavitary transplantation, diaphragmatic herniation (Figure 12) and severe liver fluke infestation. 47–51 Ultrasound is helpful in such cases to confirm the need for surgical intervention.…”

Section: Abnormalities Of the Biliary Treementioning

confidence: 99%

Feline abdominal ultrasonography: what’s normal? what’s abnormal? The biliary tree

Griffin

2019

Journal of Feline Medicine and Surgery

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Practical relevance: Abdominal ultrasound plays a vital role in the diagnostic work-up of many cats presenting to general and specialist practitioners. The biliary tree encompasses the liver, gall bladder and bile ducts, although only diseases affecting the latter two are discussed here. Diseases of the bile ducts and gall bladder are more common than those of the liver parenchyma and ultrasound plays an important role in their diagnosis. Clinical challenges: Despite ultrasonography being a commonly used modality, many practitioners are not comfortable performing an ultrasound examination or interpreting the resulting images. Even differentiating between normal variation and pathological changes can be challenging for all but the most experienced. In addition, a lack of pathological change does not necessarily rule out disease; for example, absence of gall bladder and/or extrahepatic biliary distension is not sufficient to exclude the possibility of biliary obstruction, and in many cases of cholangitis the liver and biliary tree are unremarkable on ultrasound examination. Equipment: Ultrasound facilities are readily available to most practitioners, although use of ultrasonography as a diagnostic tool is highly dependent on operator experience. Aim: This review, part of an occasional series on feline abdominal ultrasonography, discusses the appearance of the normal and diseased biliary system. It is aimed at general practitioners who wish to improve their knowledge and confidence in feline abdominal ultrasound and is accompanied by high-resolution images. Percutaneous ultrasound-guided cholecystocentesis is also covered. Ultrasound examination of the liver was discussed in an article published in January 2019 and an upcoming article will cover hepatic vascular anomalies. Evidence base: Information provided in this article is drawn from the published literature and the author’s own clinical experience.

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“…Extrahepatic biliary obstruction has also been described secondary to congenital malformations, diaphragmatic hernia, liver fluke infestation and cysts. Non-obstructive dilation of the common bile duct has been reported as well and can be caused by segmental dilation or choledochal cysts (D´Anjou and Penninck, 2015;Gaillot et al, 2007;Head and Daniel, 2005;Lawrence et al, 1992;Mayhew et al, 2002;Neer, 1992;Gaschen, 2011;Kelly et al, 1975;Mayhew and Weisse, 2008;Barsanti et al, 1976;Haines et al, 1996;Brioschi et al, 2014;Naus and Jones 1978;Della Santa et al, 2007;Spain et al,2017;Grand et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…However, the detection of specific lesion arrangement, such as focal mass or the distinction between obstructive or non-obstructive dilation of the common bile duct can be challenging (Gaillot et al, 2007). In a study by Gaillot et al (2007), describing thirty cats with extrahepatic biliary obstruction, the pancreatic origin of the triggering mass was identified in 55 % of the cats; in just 18 % of these masses the dignity was accurately recognized by ultrasound (Fahle et al,1995;Leveille et al, 1996;Gaillot et al, 2007;Brioschi et al, 2014;Spain et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

Duodenal peripapillary adenocarcinoma causing extrahepatic biliary obstruction and icterus in a cat

Rick¹,

Stock²,

Maele³

et al. 2020

VDT

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A six-year-old, female, neutered domestic shorthair cat was presented with chronic weight loss and a two-day history of partial anorexia and lethargy. Abdominal ultrasonography revealed a regional thickening of the duodenal wall with loss of normal layering, a normally walled segmentally dilated distal aspect of the common bile duct containing slightly hyperechoic bile, and a mild to moderately enlarged major duodenal papilla. Based on the ultrasound examination, the primary differential diagnosis was a peripapillary duodenal neoplastic or less likely, an inflammatory or infectious process with secondary extrahepatic biliary obstruction. Postmortem examination revealed a duodenal, peripapillary adenocarcinoma with metastasis into the liver and lymph nodes, and external compressive obstruction of cystic- and common bile duct.

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Imaging Diagnosis—extrahepatic Biliary Tract Obstruction Secondary to a Biliary Foreign Body in a Cat

Cited by 19 publications

References 21 publications

Feline biliary tree and gallbladder disease: Aetiology, diagnosis and treatment

Feline biliary tree and gallbladder disease: Aetiology, diagnosis and treatment

Feline abdominal ultrasonography: what’s normal? what’s abnormal? The biliary tree

Duodenal peripapillary adenocarcinoma causing extrahepatic biliary obstruction and icterus in a cat

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