Case of the week 6.3.19
Publication Date: 2019-06-03
History
12 year old west highland white terrier. Decreased appetite for 1 week, increase liver values. Previous history of diabetes
3 images
Findings
Orthogonal radiographs of the abdomen are available for interpretation.
The serosal detail is normal.
There are numerous pinpoint mineral opacities in the plane of the gallbladder, with some pinpoint to linear mineral opacities within the mid liver. A larger (1.3 x 0.6 cm) rectangular mineral opacity is seen in the cranial left mid abdomen, immediately adjacent to the duodenum on the VD view.
The liver is normal in size. The GI tract, spleen, and kidneys are normal. The urinary bladder is moderately distended.
There is mildly spondylosis deformans of the lumbar and lumbosacral spine. There is mild thickening of the femoral necks bilaterally.
Diagnosis
The described mineral opacities are consistent with choleliths, cholecystoliths, and choledocoliths. The larger mineral opacity adjacent to the duodenum may represent an obstructive choledocolith given the clinical history.
Degenerative osseous changes.
Discussion
Abdominal ultrasound was performed and confirmed the presence of obstrutive choledocholiths at the level of the major duodenal papilla.
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