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Posted - 27-08-2019

Very interesting and a reminder why we love CT!

BEN, a 9 year old, Cocker Spaniel, presented to the internal medicine team with jaundice. A was CT performed and the report was very interesting!

Results of the CT identified that at the level of the duodenal papilla, there was a dilation of the common bile duct followed by an abrupt decrease in diameter proximally followed by marked dilation to the level of the cystic duct and ultimately gallbladder.

The narrowing of the common bile duct occurred approximately 1.2 cm from the major duodenal papilla. The common bile duct walls showed marked contrast enhancement at the focal narrowing of the duct. In the location where the common bile duct decreased in diameter, there was a wispy soft tissue attenuation within the fat.

(The narrowing is shown here with the red arrow)

Ben underwent surgery to correct this with our surgical team. This was a complex surgery to try and re-appose the common bile duct to the duodenum. The bile duct was too short from where the dissection of the stenosis was disected. The surgeon, Michal Vlasin, opted to then de-compress biliary tract by cholecystoduodenostomy. This is a surgical procedure that bypasses the extrahepatic biliary tree and connects the gallbladder directly to the duodenum. Surgery was successful and Ben was discharged a few days later.

Ben is now home and recovering.

Vale Referrals

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