Choledochal cyst with secondary cholangitis, choledochitis, duodenal papillitis, and pancreatitis in a young domestic shorthair cat

2021 ◽  
pp. 104063872110171
Author(s):  
Megan E. Schreeg ◽  
Sybille A. Miller ◽  
John M. Cullen
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Duodenal Papilla ◽  
Choledochal Cysts ◽  
Chronic Antigenic Stimulation ◽  
Bile Drainage ◽  
Biliary Ducts ◽  
The Common ◽  
Duodenal Papillitis

Choledochal cysts, congenital segmental dilations of the common bile duct, have been reported in few cats, and histologic characterization is lacking. A 20-mo-old spayed female domestic shorthair cat was presented because of vomiting and weight loss. There was progressive elevation of liver enzyme activity (ALT > ALP, GGT) and hyperbilirubinemia. Diagnostic imaging identified focal cystic dilation of the common bile duct, dilation and tortuosity of adjacent hepatic ducts, and a prominent duodenal papilla. A choledochal cyst was suspected, and the animal was euthanized. On postmortem examination, there was a 2-cm, firm, thickened, cystic dilation of the common bile duct, patent with adjacent ducts. Histologically, the cyst wall was expanded by fibroblasts, collagen, and lymphoplasmacytic inflammation. Adjacent bile ducts were markedly dilated and tortuous, with lymphoplasmacytic inflammation and papillary mucosal hyperplasia that extended to the major duodenal papilla. There was chronic neutrophilic cholangitis, suggesting bacterial infection and/or disturbed bile drainage, extrahepatic obstruction, and lymphoplasmacytic pancreatitis with ductular metaplasia. Prominent lymphoid follicles within biliary ducts and duodenum suggested chronic antigenic stimulation. Choledochal cysts can be associated with chronic neutrophilic cholangitis, extrahepatic obstruction, choledochitis, duodenal papillitis, and pancreatitis, and should be a differential for increased hepatic enzymes and hyperbilirubinemia in young cats.

scholarly journals Slip of the T tube within the common bile duct: A little known complication of the T tube drainage

2005 ◽  
Vol 133 (3-4) ◽  
pp. 138-141
Author(s):  
Radoje Colovic ◽  
Vladimir Radak ◽  
Nikica Grubor ◽  
Slavko Matic
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Tube Drainage ◽  
X Ray ◽  
Abdominal Drain ◽  
T Tube ◽  
Tube Position ◽  
Bile Drainage ◽  
The Common ◽  
The Right

Complications related to the T tube drainage of the common bile duct are not uncommon. Some, like dislocations of the T tube out of the common bile duct, could be very serious, particularly if developed during the first few days after surgery, when the abdominal drain in the subhepatic space had been already removed. Then, an emergency reoperation might be necessary. The slip of the T tube upwards or downwards inside the common bile duct is not so rare. Fortunately, it is less dangerous and can usually be resolved without reoperation. It takes place several days after surgery, followed by the right subcostal pain, occasionally with temperature, rise of the bilirubin and with decrease or complete cessation of the bile drainage through the T tube. The diagnosis can be made only on the basis of T tube cholangiography. The re-establishment of the proper T tube position must be done under X-ray visualization. Seven cases of the T tube slip within the common bile duct, its clinical presentation, diagnosis and method of repositioning were presented. Possible mechanism of complication was described. As far as we know, the complications have not been described by other authors.

scholarly journals Case Report: Isolated Cystic Dilatation of the Cystic Duct: A Misdiagnosed Case Preoperatively

2021 ◽  
Vol 8 ◽  
Author(s):  
Jiankang Zhang ◽  
Zeming Hu ◽  
Xuan Lin ◽  
Dongliang Zhang ◽  
Hao Wang ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Cystic Duct ◽  
Extrahepatic Bile Duct ◽  
Cystic Dilatation ◽  
Liver Transaminase ◽  
Caudal Portion ◽  
The Common

A 33-year-old female with a mild elevation of liver transaminase was sent to the general surgery department for medical services due to upper-right abdominal pain for 2 weeks. A liquid dark area ~4 × 3 × 3 cm in size in the theoretical location of the pancreatic segment of the common bile duct was detected by abdominal CT with no enhancement of the cystic wall found in the enhanced CT scan. The patient was then diagnosed with a choledochal cyst based on the results of the radiological images preoperatively. During the operation, the isolated cystic dilatation was found in the middle part of the cystic duct, and its caudal portion was found behind the head of the pancreas and converged into the common bile duct at an acute angle and low insertion. According to the intraoperative evaluation, the female was then diagnosed with a cystic duct cyst (CDC). The surgery was converted to a laparotomy for the unclear structure and the possibility of anatomic variation of the bile duct. The caudal portion of the cystic duct was found communicated with the common bile duct with a narrow base, and the extrahepatic bile duct was not cystic. The CDC was removed in the surgery. One week later, the patient was discharged from the hospital for the disappearance of abdominal pain and normal liver transaminase and did not report any discomfort in the 1-month-long follow-up. The lessons drawn from this case were as follows: (1) the distinction between the relatively frequent choledochal cyst and the isolated CDC should always be taken in mind; (2) a surgical strategy should be given priority for an intraoperatively confirmed CDC; (3) a common bile duct exploration is recommended for patients with choledocholithiasis or jaundice.

scholarly journals Mobilization cholangiography

1981 ◽  
Vol 62 (5) ◽  
pp. 41-42
Author(s):  
O. S. Kochnev ◽  
V. N. Biryaltsev
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Tract ◽  
The State ◽  
Duodenal Papilla ◽  
Terminal Part ◽  
Surgical Interventions ◽  
Intraoperative Diagnosis ◽  
The Common

Determination of the state of the biliary tract and the terminal part of the common bile duct is one of the most difficult issues of intraoperative diagnosis in complicated cholecystitis. Currently, none of the surgeons doubts the need for intraoperative cholangiography and its value. It is she who allows to identify in many patients the presence of calculi in the biliary tract, to determine the degree of expansion of the common bile duct and bile hypertension, the state of the terminal part of the common bile duct. However, the analysis of radiographs performed during 170 surgical interventions for various degrees of stenosis of the large duodenal papilla showed that even this most reliable method of intraoperative diagnosis has a significant drawback.

scholarly journals NUMBER OF COMMON BILE DUCT STONES WITHOUT CHOLANGITIS CORRELATES WITH BACTERIOLOGIC ASSESSMENT OF BILE

2019 ◽  
pp. 26-29
Author(s):  
I. N. Mamontov
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Common Bile Duct Stones ◽  
Mirizzi Syndrome ◽  
Bile Duct Stones ◽  
Duodenal Papilla ◽  
E Coli ◽  
Factors Influencing ◽  
The Common ◽  
Impacted Stone

Abstract. Aim: to determine the factors influencing on bacteribilia in patients with benign obstruction of the extrahepatic biliary tract (BOEBT). Materials and Methods. A study of 30 cases of BOEBT with bacteriologic bile assessment was performed. A comparison of the incidence of different factors in patients with or without bacteriobilia was done. Results. Positive bile culture was in 22 (73.3%) patients. The most common were E. coli and Klebsiella (68.2%). There was no difference (p<0.05) in sex, age, bilirubin level, gallbladder condition, common bile duct size, major duodenal papilla (MDP) size, common bile duct stones, sludge, Mirizzi syndrome, impacted stone in MDP. Significant differences were found in number of common bile duct stones: 1-2 stones (p<0,001) and multiple stones (p<0,05). Conclusions. Risk factors for bacteriobilia is 1-2 stones in the common bile duct (p<0,001). Multiple stones (≥3) are not associated with bacteriobilia (p<0,05).

Embryonal rhabdomyosarcoma of the common bile duct mimicking choledochal cyst

2005 ◽  
Vol 12 (3) ◽  
pp. 263-265 ◽  
Author(s):  
Gulay A. Tireli ◽  
Serdar Sander ◽  
Sergulen Dervisoglu ◽  
Oyhan Demirali ◽  
Murat Unal
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Embryonal Rhabdomyosarcoma ◽  
The Common

scholarly journals Laser papillosphincterotomy in choledocholithiasis and acute biliary pancreatitis

2021 ◽  
Vol 25 (2) ◽  
pp. 48-54
Author(s):  
V. A. Lazarenko ◽  
Y. V. Kanishchev ◽  
P. M. Nazarenko ◽  
D. P. Nazarenko ◽  
T. A. Samgina ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Laser Light ◽  
Biliary Pancreatitis ◽  
Duodenal Papilla ◽  
Surgical Time ◽  
Acute Biliary Pancreatitis ◽  
Major Duodenal Papilla ◽  
The Russian Federation ◽  
The Common

Objective. The radical elimination of extrahepatic biliary tract pathology in choledocholithiasis and acute biliary pancreatitis (ABP) reduces the risk of infection and eliminates the source of endogenous intoxication; so, the search of safe and effective techniques for endoscopic papillosphincterotomy (EPT) is important.Purpose: to assess outcomes of laser-assisted endoscopic papillosphincterotomy.Material and methods. 288 patients with “wedged” (n = 111) and “valve” (n = 177) choledocholithiasis and acute biliary pancreatitis were divided into two groups depending on EPT technique: in the control group, a papillotome with electrocoagulation cord was used (n = 195); in the main group, laser scalpel was used (n = 93).Results. 87 patients with “wedged” choledocholithiasis were treated with EPT and an end electrode on the wedged stone. 16 patients out of them had mild bleeding which was stopped by irrigation with epinephrine solution (1 : 10 000) followed by the targeted coagulation. The average surgical time was 38 ± 16 min. In 24 patients with rigid and edematous medial wall of the duodenum due to acute biliary pancreatitis, the proposed device plus laser technique for papillosphincterotomy were used (patent of the Russian Federation No. 2614891). There was no bleeding, the average surgical time was 24 ± 12 min. In “valve” choledocholithiasis, laparoscopic cholecystectomy (LCE) was performed; calculi from the common bile duct were removed. In 108 patients during LCE, EPT was made via an antegrade catheter. In 69 patients with anatomical and physiological obstacles caused by the major duodenal papilla, we performed LCE and EPT with laser light via an antegrade guide light made of fluoroplastics (patent of the Russian Federation No. 41594). Concrements from the common bile duct were removed with the Dormia basket.Conclusions. Laser light causes less damage, reliably provides hemostasis along the incision line on the anterior wall of the major duodenal papilla; in addition, a wedged calculus in “wedged” choledocholithiasis and a fluoroplastic light guide in “valve” choledocholithiasis reliably protect the posterior wall of the major duodenal papilla from laser light damage. Laser techniques used in EPT make the treatment of choledocholithiasis in patients with ABP having anatomical and physiological problems due to the major duodenal papilla safe and effective.

Laparoscopic surgery for lithiasis local choledochal dilatation diagnosed a cyst: Case report and literature reviews

2021 ◽  
Vol 11 (2) ◽  
Author(s):  
Tuấn Anh Đỗ ◽  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Frozen Section ◽  
Extrahepatic Bile Duct ◽  
Intrahepatic Bile Duct ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Proper Diagnosis ◽  
The Common

Abstract Biliary dilation is common in clinical practice and originates from many pathologies; among them, choledocholithiasis, chronic pancreatitis and periampullary diverticula (PAD) are the most common. Popular signs of cholelithiasis is diffuse dilatation of the intra- and extrahepatic bile duct, however, in some cases, it might be local dilatation of the common bile duct without intrahepatic bile duct dilatation. The long-term outcome is favorable, however, it is necessary to rule out other causes such as choledochal cyst, pancreatitis by frozen section in order to have a proper diagnosis and treatment. We describe a 19-year-old female patient with local dilation of the common bile duct due to choledocholithiasis that was operated laparoscopically with success. Key word: Local common bile duct dilation, gallstones, choledochal cyst, laparoscopy. Tóm tắt Giãn đường mật là một hình thái tổn thương hay gặp trên lâm sàng, do nhiều bệnh lý khác nhau, hay gặp nhất là sỏi ống mật chủ (OMC), viêm tụy mạn và túi thừa Vater 1. Dấu hiệu phổ biến của sỏi mật là giãn đường mật trong và ngoài gan lan tỏa, tuy nhiên có trường hợp OMC giãn đơn thuần không kèm theo giãn đường mật trong gan. Tiên lượng của bệnh này là tốt, tuy nhiên cần loại trừ các nguyên nhân như nang OMC, viêm tụy bằng sinh thiết tức thì để có chẩn đoán và điều trị phù hợp nhất. Chúng tôi xin báo cáo một trường hợp người bệnh (NB) nữ, 19 tuổi mắc sỏi mật gây giãn OMC khu trú dạng nang được phẫu thuật nội soi thành công. Từ khóa: Giãn đường mật khu trú, sỏi mật, nang ống mật chủ, phẫu thuật nội soi.

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