Computed tomographic diagnosis of a common bile duct abscess and secondary extrahepatic biliary duct obstruction in a potbelly pig.

A potbelly pig was evaluated for anorexia and icterus. Clinicopathologic abnormalities suggested an active inflammatory hepatobiliary process. Ultrasound and CT of the abdomen revealed an extrahepatic biliary obstruction of the common bile duct (CBD). Surgical exploration and choledochotomy revealed a markedly dilated CBD containing a large volume of intraluminal inspissated biliary material. This case report describes the imaging findings of an extrahepatic biliary obstruction secondary to abscessation within the CBD in a pig.

A series of six cases of sphincter of Oddi pathology in the cat (2008-2009).

The sphincter of Oddi (SO) is located within the wall of the duodenum as the terminal part of the common bile duct. Six cats are reported with obstructive processes within their SO. Three of them may have had some form of sphincter dysfunction associated with the pre-existing complex known as 'inflammatory bowel disease' (IBD), two may have had the equivalent of the infant human condition known as 'bile plug syndrome' and the sixth had sphincter dysfunction associated with a tumour at the confluence of the common and right hepatic duct. In all six cases, the sphincter obstructions were surgically managed. The outcomes for 4/6 were favourable but 1/6 was euthanased intraoperatively, and 1/6 had a metastatic neoplasia and was euthanased 2 months postoperatively.

Hepaticojejunostomy for treatment of common hepatic duct obstructions associated with duodenal stenosis in two foals.

Two female Standardbred foals 2 and 3 months of age were presented with signs of gastroduodenal obstruction that was confirmed with contrast radiography and exploratory surgery. Ventral midline celiotomy was performed, showing stenosis of the duodenum proximal and distal to the hepatopancreatic ampulla. The common hepatic duct, the pancreatic duct, and the sigmoid section of the duodenum proximal to the stenosis were greatly dilated. To bypass the intestinal obstruction, a side-to-side duodenojejunostomy was performed. Obstruction of the common hepatic duct was relieved by side-to-side hepaticojejunostomy. In addition, jejunojejunostomy was performed distal to the other anastomoses. Both foals recovered. On admission, the foals' total bilirubin, aspartate aminotransferase, and gamma glutamyl transferase levels were greatly elevated. During the subsequent 6 to 8 months, they returned to normal. Six months after the first surgery, one foal was readmitted with an acute abdominal crisis. At surgery, there was greater than 360 degrees clockwise rotation of the mesenteric root involving most of the jejunum. At necropsy, the previously created stomas were patent. The liver and bile duct were grossly and histologically normal. The second foal continues to progress normally 12 months after surgery.

Common bile duct obstruction secondary to chronic fibrosing pancreatitis: treatment by use of cholecystoduodenostomy in the dog.

Six small to medium-sized, middle-aged, female dogs with histories of acute pancreatitis developed clinical signs of extrahepatic biliary obstruction. Clinical findings were similar in the 6 dogs and included icterus. Serum biochemical analyses indicated high concentrations of total bilirubin and cholesterol and high alkaline phosphatase and alanine transaminase activities. Exploratory abdominal surgery was performed in each dog. Each dog had a firm mass involving the body of the pancreas, with obstruction of the distal portion of the common bile duct, marked peripancreatic inflammation, and omental adhesions. Cholecystoduodenostomy, using an open mucosal appositional technique for biliary redirection, was performed in each dog. Clinically, results of surgery were good to excellent (ie, lack of postoperative icterus, anorexia, lethargy, or weight loss and absence or infrequency of vomiting). The mean postoperative evaluation period for the 6 dogs was 35 months (range, 20 to 48 months); 5 dogs were alive and healthy at the end of the study. Histologic examination of tissue specimens of the pancreatic mass indicated chronic active fibrosing pancreatitis in the 6 dogs.

Cholecystography and cholecystoduodenostomy in the diagnosis and treatment of bile duct obstruction in a dog.

A common bile duct obstruction was documented in a dog, by performing cholecystography haparoscopic visualization facilitated performance of the cholecystography. Target cells were a consistent hematologic finding. Cholecystoduodenostomy, an easily performed surgical technique, allowed for restoration of bile flow and resolution of clinical signs.