ISSN 2398-2950      

Bile duct: disease

ffelis
Contributor(s):

Phil Nicholls

Rachel Korman

Synonym(s): Extrahepatic bile duct obstruction, EHBDO


Introduction

  • Cause: obstruction of bile drainage from the common bile duct into the duodenum may occur due to luminal, intramural or extramural causes.
  • Signs: anorexia, vomiting, jaundice.
  • Diagnosis: clinical pathology, imaging, histopathology; most commonly is diagnosed due to subsequent liver damage/disease.
  • Treatment: surgical or medical depending on etiology.
  • Prognosis: good to poor depending on etiology.

Pathogenesis

Etiology

  • Obstruction of the biliary tract may be due to:
    • ​Inflammatory mural disease - occurring secondary to (or causing) cholangitis Liver: cholangitis. This is thought to arise as a consequence of bacterial infection ascending from the small intestine.
    • Inflammatory extramural disease - including pancreatitis Pancreatitis, lymphadenopathy Lymphadenopathy or duodenal disease.
    • Intraluminal obstruction - including sludged bile, blood clot or cholelithiasis:
      • Cholelithiasis may be incidental.
      • Bilirubin cholelithiasis has been reported in a young Somali with pyruvate kinase deficiency Pyruvate kinase deficiency.  
    • Biliary tract neoplasia.
    • Congenital or anatomical abnormalities, eg polycystic liver disease, congenital stenosis or atresia.
    • Rupture of the gall bladder or bile duct Gallbladder disease: overview:
      • Rare complication of abdominal trauma with disease due to bile peritonitis. Entrapment in a diaghragmatic hernia is also reported.
    • Infection with Patynosomum concinnum, a liver fluke, occurs in tropical and subtropical countries and can cause liver disease or be asymptomatic.

Timecourse

  • Varied, can be acute over 1-2 days, eg obstructive cholelithiasis but often insidious onset over days-weeks, eg chronic inflammatory disease or neoplasia.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Galliot H A, Penninck D G, Webster C R et al (2007) Ultrasonographic features of extrahepatic biliary obstruction in 30 cats. Vet Radiol Ultrasound 48 (5), 439-447 PubMed.
  • Harvey A M, Holt P E, Barr F J et al (2007) Treatment and long-term follow-up of extrahepatic biliary obstruction with bilirubin cholelithiasis in a Somali cat with pyruvate kinase deficiency. J Feline Med Surg 9 (5), 424-431 PubMed.
  • Brain P H, Barrs V R, Martin P et al (2006) Feline cholecystitis and acute neutrophilic cholangititis: clinical findings, bacterial isolates and response to treatment in six cases. J Feline Med Surg (2), 91-103 PubMed.
  • Eich C S & Ludwig L L (2002) The surgical treatment of cholelithiasis in cats: a study of nine cases. J Am Anim Hosp Assoc 38 (3), 290-296 PubMed.
  • Center S A (1998) Nutritional support for dogs and cats with hepatobiliary disease. J Nutr 128 (12 Suppl), 2733S-2746S PubMed.
  • Day M J (1998) Immunohistochemical characterization of the lesions of feline progressive lymphocytic cholangitis/cholangiohepatitis. J Comp Pathol 119 (2), 135-147 PubMed.
  • Pastor J, Majo N, Arbona C et al (1997) Sclerosing adenocarcinoma of the extrahepatic bile duct in a cat. Vet Rec 140 (14), 367-368 PubMed.
  • Gagne J M, Weiss D J, Armstrong P J (1996) Histopathologic evaluation of feline inflammatory liver disease. Vet Pathol 33 (5), 521-526 PubMed.
  • Léveillé R, Biller D S, Shiroma J T (1996) Sonographic evaluation of the common bile duct in cats. J Vet Intern Med 10 (5), 296-299 PubMed.
  • Adler R, Wilson D W (1995) Biliary cystadenoma of cats. Vet Pathol 32 (4), 415-418 PubMed.
  • Fahie M A, Martin R A (1995) Extrahepatic biliary tract obstruction - a retrospective study of 45 cases (1983-1993).  JAAHA 31 (6), 478-482 PubMed.
  • Jackson M W, Panciera D L, Hartmann D (1994) Administration of vancomycin for treatment of ascending bacterial cholangiohepatitis in a cat. JAVMA 204 (4), 602-605 PubMed.
  • Lawrence D, Bellah J R, Meyer D J et al (1992) Temporary bile diversion in cats with experimental extrahepatic bile duct obstruction. Vet Surg 21 (6), 446-451 PubMed.
  • Nakayama H, Uchida K, Lee S K et al (1992) Three cases of feline sclerosing lymphocytic cholangitis. J Vet Med Sci 54 (4), 769-771 PubMed.

Other sources of information

  • Balkman C (2009) Hepatobiliary neoplasia in dogs and cats. Vet Clin North Am Small Anim Pract 39 (3), 617-625 PubMed.
  • Center S A (2009) Diseases of the gallbladder and biliary tree. Vet Clin North Am Small Anim Pract 39 (3), 543-598 PubMed.
  • Day D G (1995) Feline cholangiohepatitis complex. Vet Clin North Am Small Anim Pract 25 (2), 375-385 PubMed.

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