Abstract
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.
Highlights
Extrahepatic biliary obstruction is a well-known complication in feline veterinary medicine and can be caused by mural thickening, luminal obstruction or extraluminal compression
There are some reports in cats, including inflammatory and parasitic infectious diseases, neoplastic processes and reports describing extrahepatic biliary obstruction secondary to internal occlusion such as plugs, cholelithiasis or foreign bodies
The history, clinical presentation and the laboratory results match the reports previously published in cats with extrahepatic biliary obstruction (Head and Daniel, 2005; Mayhew et al, 2002; Buote et al, 2006)
Summary
Extrahepatic biliary obstruction is a well-known complication in feline veterinary medicine and can be caused by mural thickening, luminal obstruction or extraluminal compression. Non-obstructive dilation of the common bile duct has been reported as well and can be caused by segmental dilation or choledochal cysts In a study by Gaillot et al (2007), describing thirty cats with extrahepatic biliary obstruction, the pancreatic origin of the triggering mass was identified in 55 % of the cats; in just 18 % of these masses the dignity was accurately recognized by ultrasound (Fahle et al.,1995; Leveille et al, 1996; Gaillot et al, 2007; Brioschi et al, 2014; Spain et al, 2017). The most common causes of extrahepatic biliary obstruction are choledocholithiasis and pancreatic carcinoma (Materne et al, 2000). To the authors’ best knowledge, this is the first report describing the imaging findings in an extrahepatic biliary obstruction caused by a duodenal peripapillary adenocarcinoma in a cat
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