scholarly journals Common bile duct obstruction caused by a helminth in a cat in the UK: ultrasonographic findings, histopathology and outcome

2021 ◽  
Vol 7 (1) ◽  
pp. 205511692098439
Author(s):  
Francesca Venier ◽  
Krizia Compagnone ◽  
Annette Kerins ◽  
Chantal Rosa
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Treatment Decision ◽  
Linear Structure ◽  
Biliary Tree ◽  
Biliary Duct ◽  
Duodenal Papilla ◽  
Duct Obstruction ◽  
The Common ◽  
The Uk

Case summary An 11-year-old neutered female domestic shorthair cat presented to our hospital with a 5-day history of vomiting, lethargy, anorexia and hyperbilirubinaemia, despite intravenous fluid therapy, gastroprotectants and antibiotic treatment. An abdominal ultrasound revealed a markedly distended common bile duct (diameter 6.2 mm). The cystic duct and intrahepatic bile ducts were also dilated. A linear structure formed by two parallel hyperechoic lines was identified in the common bile duct and could be traced to the duodenal papilla. The cat underwent laparotomy for surgical decompression of the biliary tree. A tubular, brown-coloured structure was retrieved from the common bile duct. Histological examination was consistent with a degenerate helminth. The cat recovered uneventfully from the surgery and its demeanour and appetite improved rapidly over the following days. Liver and gallbladder wall histopathology was consistent with bacterial cholangitis and cholecystitis. Escherichia coli was cultured from both bile and liver parenchyma. Relevance and novel information To our knowledge, this is the first reported case of extrahepatic biliary duct obstruction caused by a helminth in a cat in the UK. We hypothesised that the obstruction had been caused by the aberrant migration of an intestinal nematode that became lodged in the duodenal papilla. Ultrasound allowed prompt diagnosis and guided the treatment decision.

scholarly journals Expanded polytetrafluoroethylene in canine bile duct injury: a critical analysis

2011 ◽  
Vol 26 (4) ◽  
pp. 247-252 ◽  
Author(s):  
Alberto Schanaider ◽  
Vera Lucia Nunes Pannain ◽  
Lucas Cristo Conilho Macedo Müller ◽  
Maria Cristina Araújo Maya
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Biliary Tree ◽  
Surrounding Tissue ◽  
Biliary Duct ◽  
Expanded Polytetrafluoroethylene ◽  
Microscopic Evaluation ◽  
Feasible Option ◽  
The Common ◽  
Group 2

PURPOSE: Analyze the morphological and structural outcomes of a patch of expanded polytetrafluoroethylene in the treatment of an iatrogenic injury of the common bile duct. METHODS: In Group 1 (Sham), 7 dogs underwent 3 laparotomies with intervals of 30 days between them. In Group 2, 10 dogs underwent transient common bile duct obstruction. After 30 days, this biliary occlusion was undone and a patch of expanded polytetrafluoroethylene replaced a fragment removed from the duct's wall. Thirty days after this last surgery, cholangiographic assessment of prosthesis patency and macro and microscopic evaluation of the biliary tract were performed. Daily clinical inspection completed the study outcomes. The Wilcoxon non-parametric test was used for statistical analysis. RESULTS: In all dogs enlargement of the biliary tree diameter was observed 30 and 60 days after the first surgical procedure. Partial adhesion of the patch to the common bile duct as a free luminal foreign body was found in 6 dogs. The prosthesis was completely integrated to surrounding tissue in the remaining four. CONCLUSION: Although a feasible option for the treatment of biliary duct iatrogenic lesions, the expanded polytetrafluoroethylene prosthesis must be used with caution considering the potential risks for complications.

scholarly journals Endoscopic Fistulotomy – ‘The Suprapapillary Punch’: A Method of Access to the Bile Duct during ERCP

1994 ◽  
Vol 8 (1) ◽  
pp. 33-35
Author(s):  
Noel B Hershfield
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Biliary Tree ◽  
Usual Method ◽  
Endoscopic Retrograde ◽  
The Common ◽  
A Minor ◽  
Endoscopic Fistulotomy

Endoscopic retrograde cholangiopancreatography (ERCP) is established as the method of choice to investigate the biliary tree when obstruction is suspected. On rare occasions, the papilla cannot be entered because of anatomical or pathological abnormalities. This report describes endoscopic fistulotomy or the suprapapillary punch that has been carried out at the Foothills Hospital in Calgary, Alberta, on 30 of 623 patients referred for ERCP for conditions causing obstruction of the common bile duct or suspected obstruction of the common bile duct. The following communication also describes the method of suprapapillary punch or endoscopic fistulotomy. Results have been excellent with only one complication, a minor attack of pancreatitis after the procedure. In summary, the suprapapillary punch or fistulotomy is a safe and useful method for entering the common bile duct when access by the usual method is impossible.

Mechanical jaundice caused by common bile duct obstruction due to hepato-biliary ascariasis

2021 ◽  
pp. 20-24
Author(s):  
Zaipula Zulbegovich Nazhmudinov ◽  
Abdulkamal Guseynovich Guseynov
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Obstructive Jaundice ◽  
Surgical Intervention ◽  
Duct Obstruction ◽  
Biliary Ascariasis ◽  
Modern Methods ◽  
Common Bile Duct Obstruction ◽  
The Common ◽  
The Right

The paper presents a case of successful surgical treatment of a patient with common bile duct ascariasis, which caused obstructive jaundice. Modern methods of examining a patient with obstructive jaundice did not allow to make the right diagnosis of the common bile duct ascariasis before surgical intervention. The rarity of this pathology arouses interest in this material.

scholarly journals Computed Tomography Imaging in Lemmel Syndrome: A Report of Two Cases

2019 ◽  
Vol 9 ◽  
pp. 23
Author(s):  
Giulia Frauenfelder ◽  
Annamaria Maraziti ◽  
Vincenzo Ciccone ◽  
Giuliano Maraziti ◽  
Oliviero Caleo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Acute Abdominal Pain ◽  
Imaging Modality ◽  
Biliary Duct ◽  
History Of ◽  
The Common ◽  
Solid Lesions

Lemmel syndrome is a rare and misdiagnosed cause of acute abdominal pain due to a juxtapapillary duodenal diverticulum causing mechanical obstruction of the common bile duct. Frequently, patients suffering from Lemmel syndrome have a history of recurrent access to the emergency room for acute abdominal pain referable to a biliopancreatic obstruction, in the absence of lithiasis nuclei or solid lesions at radiological examinations. Ultrasonography (US) may be helpful in evaluation of upstream dilatation of extra-/intra-hepatic biliary duct, but computed tomography (CT) is the reference imaging modality for the diagnosis of periampullary duodenal diverticula compressing the intrapancreatic portion of the common bile duct. Recognition of this entity is crucial for targeted, timely therapy avoiding mismanagement and therapeutic delay. The aim of this paper is to report CT imaging findings and our experience in two patients affected by Lemmel syndrome.

scholarly journals Laparoscopic exploration of bile ducts in patients with calculosis. indications, methods and first results

Folia Medica ◽  
2013 ◽  
Vol 55 (3-4) ◽  
pp. 33-38 ◽  
Author(s):  
Rosen S. Dimov ◽  
Rangel I. Kantchev ◽  
Boris G. Boev ◽  
Todor I. Ivanov ◽  
Ilia A. Apostolov ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Gall Stone ◽  
Sphincter Of Oddi ◽  
Biliary Tree ◽  
Stone Extraction ◽  
Average Hospital ◽  
Laparoscopic Exploration ◽  
Ultrasound Study ◽  
The Common

ABSTRACT INTRODUCTION: In the last few years there has been a resurgence of laparoscopic exploration of the common bile duct as an alternative to endoscopic retrograde cholangiopancreatography (ERCP), the primary method for diagnosis and treatment of biliary tract calculosis. AIM: The aim of this study was to clarify the indications and methods for performing laparoscopic bile duct exploration, based on our experience in the field and data from the literature. PATIENTS AND METHODS: We recruited 12 patients who underwent laparoscopic exploration and stone extraction from the common bile duct (CBD) in the surgical ward of Kaspela Hospital, Plovdiv over the period January 2011 to January 2012. The diagnostic and therapeutic modalities used in the study included laboratory tests, ultrasound study, CT, ERCP, digital cholangiography, clamp and balloon stone extraction, primary suture and choledochoduodenostomy. RESULTS: Stone extraction was successfully performed in 8 patients using the transcystic approach through an incision used in the cholangiography. The procedure failed in the remaining four patients and we used here 2-cm longitudinal choledochotomy. In two patients the control cholangiography following the extraction of stones demonstrated complete clearance of the biliary tree and free passage of contrast agent from bile duct to duodenum (patent ampulla of Vater). In these two patients we performed a primary closure of the choledochotomy with a single interrupted suture (“ideal choledochotomy”). In two patients from the choledochotomy group, the control cholangiography showed the presence of residual stones or fragments trapped above the sphincter of Oddi with no contrast medium in the duodenum. In these cases we completed this procedure with latero-lateral choledochoduodenostomy by Flërken. All patients had a smooth postoperative course with no recorded complications. The average hospital stay was 5 days. CONCLUSIONS: Laparoscopic exploration of the biliary ducts in calculosis is an efficient, safe and reliable method to manage this serious complication of gall-stone disease in the hands of an experienced laparoscopic surgeon. The results of its application are comparable and in some cases even better than those of ERCP used as a therapeutic procedure as regards clearance of the CBD and the complications involved in these two procedures.

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).

Permeability of the rat biliary tree to ursodeoxycholic acid

1989 ◽  
Vol 256 (4) ◽  
pp. G653-G660
Author(s):  
O. Farges ◽  
M. Corbic ◽  
M. Dumont ◽  
M. Maurice ◽  
S. Erlinger
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Ursodeoxycholic Acid ◽  
Hepatic Duct ◽  
Biliary Tree ◽  
Left Hepatic Duct ◽  
Biliary Epithelium ◽  
Isolated Segment ◽  
The Common

The permeability of the biliary epithelium to [14C]ursodeoxycholic acid (UDCA), a hypercholeretic bile acid, was compared to that of the 14C-labeled nonhypercholeretic bile acids cholic acid (CA), taurocholic acid (TCA), and tauroursodeoxycholic acid (TUDCA) by means of anterograde intrabiliary infusions and retrograde intrabiliary injections in the anesthetized rat. Anterograde intrabiliary infusions were performed by perfusing an isolated segment of common bile duct in vivo. After anterograde intrabiliary infusions, the fraction of unrecovered UDCA (that had presumably been absorbed from the biliary lumen) was 11.03 +/- 1.03 (SE)% (n = 6) of the administered dose. It was significantly higher than that of TUDCA (1.25 +/- 0.27%; n = 5; P less than 0.01), CA (2.62 +/- 0.43%; n = 4; P less than 0.01), and TCA (2.57 +/- 0.79%; n = 6; P less than 0.01). In separate experiments, bile was collected from the common bile duct and from the left hepatic duct. UDCA recovered from the left hepatic duct was found in the conjugated form, indicating that, after absorption in the common bile duct, it had been conjugated by the hepatocyte and secreted into bile. After retrograde intrabiliary injections of UDCA and CA, the cumulative percentages of recovered radioactivity were not significantly different (84.50 +/- 2.65 and 87.33 +/- 1.80%, respectively); however, peak recovery of UDCA was significantly delayed compared with that of CA. Moreover, UDCA was recovered mostly in the conjugated form, while CA was recovered mostly in the unconjugated form. These results suggest that, in the rat, UDCA is significantly more absorbed by the biliary tree than CA, TUDCA, and TCA. They support the hypothesis that UDCA undergoes a cholehepatic circulation.

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