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Gall Bladder Disease - Coggle Diagram
Gall Bladder Disease
cholecystitis
diagnosis
US
thickened wall
immobile biliary sludge
common bile duct distention
hyperechoic
free abdominal fluid
can be in gall bladder or bile duct
:arrow_up:
ALP
ALT
+/- bilirubin
GGT
cholesterol +/-
leukocytosis
cholescystocentesis
inflammation of the gall bladder
+/- bacterial infection
bile stasis
accumulation of cytotixic bile acids
choleliths
mucocele
gall bladder rupture risk
older dogs :dog:
icterus uncommon
treatment
medical management
abx after C&S
6-8w
ursodeoxycholic acid (10-15mg/kg PO q24h)
denamarin/SAMe
repeat bloodwork every 2w until resolved
follow-up cholecysto
surgical management
indicated if...
bile duct obstruction
evidence by hyperbilirubinema
gall bladder rupture
medical management failure
CS
:eye:
chronic
asymptomatic
waxing/waning appetite
episodic
acute
vomiting
diarrhea
icterus
shock
anorexia
possible none :woman-shrugging:
:hand:
abdominal pain
:microscope:
inflammatory leukogram +/- let shift
:arrow_up:
bilirubin
ALP, GGT
ALT, AST
cholesterol
typically concurrent conditions to biliary infections
mucocele
collection of gelatinous material that distends the gall bladder
proliferation of mucus producing cells
impedes emptying
alters bile composition
breed disposition
cocker spaniels
sheltie
mini schnauzer
diagnosis
US
kiwi appearance
gall ladder and duct dilation
thickened wall (>2mm)
no free flowing bile or bile consolidation in center
contrast enhancement is an option
abdominocentesis
CT
histopath
culture
usually negative
spp
E coli
Enterococcus
Staph
Clostridium perfringens
typically performed at surgery
can progress to bile peritonitis
pressure necrosis
rupture
challenging to diagnose
regional effusion
on US
hyperechoic mesentery
extraluminal sludge
concurrent conditions
Cushings
hypothyroidism
hepatobiliary dz
hypertriglyceridemia
diabetes
treatment
medical management
denamarin/SAMe
monitoring
+/- abx
bilirubin
liver enzymes
abdominal pain
GI signs
ursodiol/actigal
address concurrent dz
surgical management
prognosis
mortality 20-40%
ruptured?
bile peritonitis?
high lactate =/= negative prognosis
cholelithiasis
usually incidental
diagnosis
adbo rads
CT (lol)
cholecytocentesis
cytology
culture
treatment
usually none
cannot be dissolved
surgery
cholecystotemy
histopathology
chronic cholecystisis
mucosal hyperplasia
pretty rare
calcification
cholangitis
inflammation of the bile duct
usually bacterial
