Spain Heather N, Penninck Dominique G, Webster Cynthia Rl, Daure Evence, Jennings Samuel H
Cummings School of Veterinary Medicine at Tufts University, North Grafton, MA, USA.
JFMS Open Rep. 2017 Jun 27;3(1):2055116917716881. doi: 10.1177/2055116917716881. eCollection 2017 Jan-Jun.
This case series documents ultrasonographic and clinicopathologic features of four cats with marked segmental dilatations of the common bile duct (CBD). All cats had additional ultrasonographic changes to the hepatobiliary system, including hepatomegaly, tubular to saccular intra/extrahepatic biliary duct dilatation and biliary debris accumulation. Based on all available data the presence of extrahepatic biliary duct obstruction (EHBDO) was ruled out in 3/4 cases and was equivocal in one case. One cat underwent re-routing surgery to address the CBD dilatation after multiple recurrent infections, one cat was euthanized and had a post-mortem examination and two cats were medically managed with antibiotics, liver protectants, gastroprotectants and cholerectics.
The ultrasonographic features of the CBD in this population of cats were supportive of choledochal cysts (CCs). The maximal diameter of the CBD dilatations exceeded 5 mm in all cases, a sign that has been previously reported to be consistent with EHBDO. In our study, dilatations were segmental rather than diffuse. Given the high morbidity and mortality associated with hepatobiliary surgery in cats, segmental dilatation of the CBD should not prompt emergency surgery. Some cats may respond to medical management. Careful planning for cyst resection was beneficial in one cat. Evaluation of CC morphology (eg, size, location, concurrent intrahepatic anomalies) may assist in selecting cats that could benefit from surgical intervention.
本病例系列记录了4只猫胆总管（CBD）明显节段性扩张的超声及临床病理特征。所有猫的肝胆系统均有其他超声变化，包括肝脏肿大、肝内外胆管呈管状至囊状扩张以及胆汁碎片积聚。根据所有可用数据，4例中有3例排除了肝外胆管梗阻（EHBDO），1例情况不明确。1只猫在多次反复感染后接受了重新布线手术以解决CBD扩张问题，1只猫实施安乐死后进行了尸检，另外2只猫接受了抗生素、肝脏保护剂、胃保护剂和利胆剂的药物治疗。
该猫群中CBD的超声特征支持胆总管囊肿（CCs）。所有病例中CBD扩张的最大直径均超过5mm，这一迹象先前已报道与EHBDO一致。在我们的研究中，扩张是节段性的而非弥漫性的。鉴于猫肝胆手术的高发病率和死亡率，CBD节段性扩张不应促使进行急诊手术。一些猫可能对药物治疗有反应。对1只猫进行囊肿切除的精心规划是有益的。评估CC形态（如大小、位置、并发肝内异常）可能有助于选择可从手术干预中获益的猫。
