Gallbladder mucocoele: A review.

Tesh M Smalle,Alane K Cahalane,Liza S Köster

doi:10.4102/jsava.v86i1.1318

Abstract

Gallbladder mucocoele (GBM) is an abnormal, intraluminal accumulation of inspissated bile and/or mucous within the gallbladder. Older, small- to medium-breed dogs seem to be predisposed, but no sex predilection has been identified. Clinical signs are often non-specific and include vomiting, lethargy, anorexia, abdominal pain, icterus and polyuria–polydipsia. Results of a complete blood count may be unremarkable, but serum biochemistry usually reveals increased liver enzymes. The ultrasonographic appearance is diagnostic and well described in the literature. Surgical intervention for the treatment of GBM remains the therapeutic gold standard, with short- and long-term survival for biliary surgery being 66%. The worst outcome is seen in those dogs requiring cholecystoenterostomy. With GBM becoming an apparently increasingly common cause of extrahepatic biliary disease in canines, it is essential that clinicians become familiar with the current literature pertaining to this condition. Numerous predisposing factors are highlighted in this review article and the role of certain endocrinopathies (e.g. hyperadrenocorticism and hypothyroidism) in the development of GBM is touched upon. Furthermore, the aetiopathogenesis of this disease is discussed with reference to the latest literature. Cholecystectomy remains the treatment of choice, but other options are considered based on a current literature review.

Highlights

Over the past decade, gallbladder mucocoeles (GBM) have become a frequently recognised cause of extrahepatic biliary (EHB) disease in canines (Aguirre et al 2007; Quinn & Cook 2009)
When EHB obstruction develops, gallbladder distension often leads to necrosis of the gallbladder wall and eventual rupture, with subsequent peritonitis (Worley, Hottinger & Lawrence 2004)
At the time of diagnosis, dogs are frequently suffering from concurrent problems that include pancreatitis, hyperlipidaemia, corticosteroid excess, hypothyroidism, protein-losing nephropathy, diabetes mellitus, cholestasis and gallbladder dysmotility (Aguirre et al 2007)

Summary

Introduction

Gallbladder mucocoeles (GBM) have become a frequently recognised cause of extrahepatic biliary (EHB) disease in canines (Aguirre et al 2007; Quinn & Cook 2009). Cholestasis may predispose animals to the development of GBM by increasing the contact time and allowing bile to become concentrated. This results in the irritation of the gallbladder wall and increased mucous production (Mesich et al 2009; Quinn & Cook 2009).

Results

Conclusion