Ultrasonographic and clinicopathologic features of segmental dilatations of the common bile duct in four cats

Spain, Heather N; Penninck, Dominique G.; Webster, Cynthia R. L.; Daure, Evence; Jennings, Sydney

doi:10.1177/2055116917716881

Cited by 12 publications

(28 citation statements)

References 30 publications

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“…Abdominal ultrasound in each case revealed segmental dilation of the CBd up to 5 cm in diameter, concurrent tubular to saccular intra-and extrahepatic bile duct dilation, accumulation of echogenic debris within the biliary tree and hepatomegaly. 59 No bile duct obstruction was identified in three of the cats described in this report (obstruction was considered equivocal in one case) and, despite marked dilation of the biliary tree on ultrasound, only one cat had (mild) hyperbilirubinaemia. However, because the maximum diameter of the dilated CBd segment exceeded 5 mm in all cases, this could easily have led to a misdiagnosis of EHBo.…”

Section: Continued From Page 438mentioning

confidence: 60%

“…Cysts that communicate with the biliary tree are known as choledochal cysts and are defined as segmental cystic dilations of extrahepatic and/or intrahepatic biliary ducts. 59 Segmental dilation of the CBd consistent with choledochal cyst formation has been described in two cats. 60,61 Both presented with non-specific clinical signs that included weight loss and both were icteric on physical examination.…”

Section: Cystsmentioning

confidence: 89%

“…Cysts that communicate with the biliary tree are known as choledochal cysts and are defined as segmental cystic dilations of extrahepatic and/or intrahepatic biliary ducts. 59…”

Section: Abnormalities Of the Biliary Treementioning

confidence: 99%

“…More recently, the ultrasonographic findings in a case series of four cats with suspected choledochal cysts arising from the CBD have been reported. 59 All four were middle-aged to older neutered domestic shorthair cats with a history of chronic vomiting, reduced appetite and lethargy. Abdominal ultrasound in each case revealed segmental dilation of the CBD up to 5 cm in diameter, concurrent tubular to saccular intra- and extrahepatic bile duct dilation, accumulation of echogenic debris within the biliary tree and hepatomegaly.…”

Section: Abnormalities Of the Biliary Treementioning

confidence: 99%

“…While some cats with choledochal cysts may exhibit only mild clinical signs despite marked dilation of the biliary tree, other choledochal cysts can result in biliary stasis and a predisposition to recurrent biliary tract infections. 59 It may be possible to manage some cats with medical treatment alone, although surgical intervention should be considered on a case-by-case basis.…”

Section: Abnormalities Of the Biliary Treementioning

confidence: 99%

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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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Section: Continued From Page 438mentioning

confidence: 60%

Section: Cystsmentioning

confidence: 89%

“…Cysts that communicate with the biliary tree are known as choledochal cysts and are defined as segmental cystic dilations of extrahepatic and/or intrahepatic biliary ducts. 59…”

Section: Abnormalities Of the Biliary Treementioning

confidence: 99%

Section: Abnormalities Of the Biliary Treementioning

confidence: 99%

Section: Abnormalities Of the Biliary Treementioning

confidence: 99%

See 3 more Smart Citations

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

Griffin

2019

Journal of Feline Medicine and Surgery

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Imaging findings and monitoring of a rare case of congenital intrahepatic bile duct ectasia (Caroli‐like disease) and a pancreatic cyst in a 2‐month‐old cat

Glăvan

2022

Vet Record Case Reports

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The case report described ultrasonographic and CT findings of a rare congenital bile duct ectasia in a cat and follow-up examinations for the assessment of the pathological process. Congenital intrahepatic bile ducts ectasia is a rare hereditary disorder of the biliary tree in dogs and cats, with a limited number of published reports documenting this pathology. Complete ultrasound examination may facilitate differentiation from other conditions and aids diagnosis, especially when cystic lesions are recorded in other abdominal organs (pancreas, kidneys). Clinical signs associated with the disease are represented by acute abdominal pain, lethargy, vomiting and diarrhoea, jaundice and abdominal distension in cases of hepatomegaly or ascites due to portal hypertension. Similarly, a delay in growth may be seen in some patients when systemic shunts or arteriovenous fistulisations coexist. Follow-up ultrasound examinations proved beneficial in order to assess the changes and further medical planning.

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Challenging diagnostic work-up of a massive fluid-filled structure in the cranial abdomen of a cat

Fels

Hungerbühler

Dziallas

et al. 2021

Tierarztl Prax Ausg K Kleintiere Heimtiere

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A 9-year-old female, neutered European shorthair cat was presented with acute vomiting, obvious jaundice and painful enlargement of the abdomen. Icteric skin and mucous membranes in addition to severe bilirubinaemia (mainly direct bilirubin) and a large increase in liver enzyme activities were the main findings at the initial examination. Radio- and ultrasonographic evaluation revealed a massive fluid-filled structure caudal to the liver displacing abdominal organs, in particular the stomach. As this structure with a diameter of 8–10 cm occupied considerable space in the cranioventral abdomen, a detailed ultrasonographic examination of the liver and the gallbladder, and determination of the structure’s association with a particular abdominal organ was initially impossible. Via ultrasound-assisted puncture under general anaesthesia 300 ml of an almost clear fluid could be aspirated. Cytological examination revealed a cyst content-like fluid with cell detritus.Further ultrasonographic and computed tomographic diagnostics followed by abdominal laparotomy finally enabled diagnosis of a cystic dilatation of the entire common bile duct and accumulation of white bile. Histopathological examination after euthanasia (requested by the owner) identified lymphoplasmacytic cholangitis and necrosis of the duodenal papilla. The massive dilatation of the common bile duct complicated its definite diagnosis by diagnostic imaging methods. It was most likely caused by a longer-standing obstruction of the bile flow by lymphoplasmacytic cholangitis with necrosis and granulation tissue formation in the area of the duodenal papilla. An interesting but initially misleading feature was the presence of white bile. The etiology of this extremely rare condition remains obscure but in the described case a manifestation of impaired hepatocyte function secondary to biliary stasis is suspected to be the cause.

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Ultrasonographic and clinicopathologic features of segmental dilatations of the common bile duct in four cats

Cited by 12 publications

References 30 publications

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

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

Imaging findings and monitoring of a rare case of congenital intrahepatic bile duct ectasia (Caroli‐like disease) and a pancreatic cyst in a 2‐month‐old cat

Challenging diagnostic work-up of a massive fluid-filled structure in the cranial abdomen of a cat

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