Duodenal ganglioneuromatosis causing common bile duct obstruction in a dog

2019 ◽  
Vol 7 (3) ◽  
pp. e000801
Author(s):  
Pauline Deprez ◽  
Jean-Guillaume Grand ◽  
Nathaniel Harran
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Obstruction ◽  
Ganglion Cells ◽  
Exploratory Laparotomy ◽  
Intestinal Wall ◽  
Abdominal Ultrasonography ◽  
Extrahepatic Biliary Obstruction ◽  
The Common ◽  
Intestinal Ganglioneuromatosis

A 3-year-old intact female labrador retriever dog was presented for anorexia, weight loss and vomiting. Abdominal ultrasonography revealed a mass of the descending duodenum involving the major duodenal papilla with loss of the normal intestinal wall layering. The distal part of the common bile duct was circumferentially thickened obliterating its lumen and causing extrahepatic biliary obstruction. Exploratory laparotomy was undertaken, total descending duodenum excision with gastrojejunostomy, cholecystojejunostomy and pancreaticojejunostomy procedures were performed. The dog died 3 days postoperatively. Histopathological and immunohistochemistry examinations of the specimens from the duodenectomy demonstrated multinodular to diffuse intestinal ganglioneuromatosis. This is the first reported case of an intestinal ganglioneuromatosis, a rare hyperplastic proliferation of ganglion cells and nerves of the enteric autonomic nervous system, involving the duodenum and causing extrahepatic biliary obstruction.

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

2020 ◽  
Vol 89 (5) ◽  
pp. 273-277
Author(s):  
T. Rick ◽  
E. Stock ◽  
I. Van de Maele ◽  
E. Kammergruber ◽  
J. Saunders
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Obstruction ◽  
Ultrasound Examination ◽  
Duodenal Wall ◽  
Abdominal Ultrasonography ◽  
Extrahepatic Biliary Obstruction ◽  
History Of ◽  
The Common ◽  
Distal Aspect

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.

scholarly journals Emergency open surgery with a duodenotomy and successful removal of an impacted basket following a complicated endoscopic retrograde cholangiopancreatography procedure: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Ibrahim Abu Shakra ◽  
Maxim Bez ◽  
Amitai Bickel ◽  
Mahran Badran ◽  
Fahed Merei ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Open Surgery ◽  
Rare Complication ◽  
Exploratory Laparotomy ◽  
Biliary Stones ◽  
Endoscopic Retrograde ◽  
Abdominal Ultrasonography ◽  
The Common

Abstract Background Current management of choledocholithiasis entails the use of endoscopic retrograde cholangiopancreatography (ERCP) and clearance of the common bile duct. A rare complication of this procedure is the impaction of the basket by a large stone, which necessitates lithotripsy. Here we report a case of an impacted basket during ERCP, which was managed by open surgery with a duodenotomy and the manual removal of the basket. Case presentation A 79-year-old Caucasian man was admitted to our department with yellowish discoloration of urine, skin and eyes. Abdominal ultrasonography showed a slightly thickened gallbladder, multiple gallbladder stones, dilated intrahepatic bile ducts and extrahepatic bile extending to 1.1 cm. A computed tomography (CT) scan demonstrated a stone in the common bile duct, which caused dilation of the biliary ducts. The patient was diagnosed with obstructive jaundice secondary to choledocholithiasis; and underwent an ERCP, a sphincterotomy and stone extraction. Four days following discharge, the patient was readmitted with jaundice, abdominal pain, vomiting and fever. He was diagnosed with ascending cholangitis and treated initially with antibiotics. A second ERCP revealed a dilated common bile duct and choledocholithiasis. Stone removal with a basket failed, as did mechanical lithotripsy. Finally, the wires of the basket were ruptured and stacked in the common bile duct together with the stone. During exploratory laparotomy, adhesiolysis, a Kocher maneuver of the duodenum and a subtotal cholecystectomy were performed. Choledochotomy did not succeed in removing the impacted wires together with the stone. Therefore, a duodenotomy and an extension of the sphincterotomy were performed, followed by high-pressure lavage of the common bile duct to remove additional small biliary stones. The choledochotomy and duodenotomy were closed by a one-layer suture, and a prophylactic gastroenterostomy was performed to prevent leakage from the common bile duct and the duodenum. The postoperative course was satisfactory. Conclusions This is the first report in the literature of removal of an impacted Dormia basket through the papilla by performing a duodenotomy and an extension of the sphincterotomy, followed by gastroenterostomy.

Diagnostic Accuracy of Ultrasound in Correlation to Alkaline Phosphatase Levels in Patients with Biliary Obstructions

2020 ◽  
pp. 26-32
Author(s):  
OJS Admin
Keyword(s):  
Alkaline Phosphatase ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Diagnostic Accuracy ◽  
Screening Method ◽  
Biliary Tract Disease ◽  
Initial Screening ◽  
Abdominal Ultrasonography ◽  
The Common ◽  
Tract Disease

Abdominal Ultrasonography (USG) is an appropriate initial screening method for detection of biliary tract disease the consultants sometimes encounter patients who only have findings of dilatation of the Common Bile Duct (CBD) on US without specic biliary symptoms or jaundice.

scholarly journals Metastatic melanoma presenting as malignant biliary obstruction of the common bile duct demonstrated with single-operator digital cholangioscopy

VideoGIE ◽  
2017 ◽  
Vol 2 (10) ◽  
pp. 266-267
Author(s):  
Prapimphan Aumpansub ◽  
Phonthep Angsuwatcharakon ◽  
Naruemon Wisedopas ◽  
Wiriyaporn Ridtitid ◽  
Rungsun Rerknimitr
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Metastatic Melanoma ◽  
Biliary Obstruction ◽  
Malignant Biliary Obstruction ◽  
Single Operator ◽  
The Common

scholarly journals Brunner’s gland hamartoma: a cause of the double-duct sign

2016 ◽  
Vol 98 (6) ◽  
pp. e92-e93 ◽  
Author(s):  
M Kostalas ◽  
P Jackson ◽  
N Karanjia
Keyword(s):  
Weight Loss ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Pancreatic Duct ◽  
Biliary Obstruction ◽  
Rare Case ◽  
Periampullary Cancer ◽  
Brunner’S Gland ◽  
The Common ◽  
Brunner's Gland

Introduction Brunner’s glands are submucosal glands found in the duodenum. Proliferation of these glands can lead to the formation of Brunner’s gland hamartomas (BGHs), which are uncommon, asymptomatic and usually found incidentally. They are predominantly benign lesions, but instances of malignant transformation have been reported. Case History We describe a rare case in which a periampullary lesion was causing biliary obstruction on a background of weight loss, and was associated with dilatation of the common bile duct and pancreatic duct on computed tomography and magnetic resonance imaging. Further investigation with endoscopic ultrasound and biopsy did not provide a definitive diagnosis. Given the symptoms and findings upon investigations, we proceeded to pylorus-preserving pancreatoduodenectomy. Conclusions This was a rare case in which BGH gave rise to biliary obstruction against a background of weight loss. Due to a high index of suspicion (weight loss and evidence of dilatation of the common bile duct and pancreatic duct), this procedure was justified because the consequences of a missed periampullary cancer far outweighed surgical risks.

scholarly journals Novel Multicentric Hepatic Lymphoma with Extrahepatic Biliary Obstruction Associated with Duodenal Perforation in a Cat

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Isabella Hildebrandt ◽  
Adam Rudinsky ◽  
Valerie Parker ◽  
Jenessa Winston ◽  
Alexandra Wood ◽  
...  
Keyword(s):  
T Cell ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Obstruction ◽  
Cell Lymphoma ◽  
T Cell Lymphoma ◽  
Duodenal Perforation ◽  
Duct Carcinoma ◽  
Peritoneal Effusion ◽  
Extrahepatic Biliary Obstruction

An 11-year-old male castrated domestic shorthair cat was presented for evaluation due to clinical deterioration and potential extrahepatic biliary obstruction (EHBO). Further investigations confirmed EHBO and revealed severe and previously unreported comorbidities. On initial examination, the cat was markedly icteric with a poor body condition score and severe muscle wasting. Serum chemistry and complete blood count showed evidence of cholestasis and anemia. Primary diagnostics and therapeutics targeted these abnormalities. Abdominal ultrasound revealed peritoneal effusion, multifocal mixed echogenic hepatic and splenic foci, small intestinal thickening, cholelithiasis, choledocholithiasis, and common bile duct and pancreatic duct dilation with evidence of obstruction. Peritoneal effusion cytology confirmed septic peritonitis. Hepatic and splenic cytology was consistent with lymphoma. Based on these results, euthanasia was elected by the owners of the animal. Necropsy confirmed the ultrasound diagnoses, septic peritoneal effusion associated with a duodenal perforation, multiorgan lymphoma, and common bile duct carcinoma. Flow cytometry classified the lymphoma as a double-negative phenotype of T-cell lymphoma (CD3+ and CD5+, but CD4- and CD8-) present in the duodenum and liver and suspected in the spleen which has previously not been reported in cats. This case report documents a cat with EHBO caused by multiple disease processes including a novel T-cell lymphoma phenotype, biliary carcinoma, duodenal perforation and septic abdomen, and choleliths, as well as inflammatory hepatobiliary disease.

scholarly journals Mirizzy syndrome complicated by acute cholangitis in pregnant

2020 ◽  
Vol 25 (1) ◽  
pp. 124-128
Author(s):  
A. V. Osipov ◽  
A. E. Demko ◽  
D. A. Surov ◽  
I. A. Soloviev ◽  
A. V. Sviatnenko ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Case Report ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Surgical Procedure ◽  
Biliary Obstruction ◽  
Acute Cholangitis ◽  
The Common

A case report of the patient at week 21 of pregnancy with Mirizzi type 2 syndrome complicated by acute cholangitis is described. During the examination, the level and cause of the biliary obstruction (cholecystocholedocheal fistula and gallstone of the common bile duct) were revealed. A detailed description of the surgical procedure is presented: subtotal laparoscopic cholecystectomy, choledochotomy, choledochoscopy, lithoextraction, drainage of the common bile duct. The analysis of information from literature sources is carried out.

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