Cholecystocutaneous fistula containing multiple gallstones in a dog.

A 7-year-old dog was presented with a history of an open lesion on the right thoracic wall, discharging honey-like fluid and small stones. Ultrasonography and computed tomographic fistulography identified a cholecystocutaneous fistula; cholecystectomy was curative. Veterinarians should consider this disease in patients with long-term discharging lesions on the right thoracic or abdominal wall.

Fistule cholécystocutanée contenant des cholélithes multiples chez un chien. Un chien âgé de 7 ans a été présenté avec une anamnèse de lésion ouverte sur la paroi thoracique droite, d'où s'écoulait un liquide ressemblant à du miel et de petits calculs. Une échographie et une fistulographie tomographique ont identifié une fistule cholécystocutanée et une cholécystectomie a guéri l'affection. Les vétérinaires devraient considérer cette maladie chez les patients ayant des lésions suppurantes de longue date sur la paroi thoracique ou abdominale droite.(Traduit par Isabelle Vallières).

Spontaneous cholecystocutaneous fistula in a dog.

The purpose of this case report was to describe the surgical correction of a cholecystocutaneous fistula in a dog. A 6 yr old Vizsla presented with a 2 mo history of a chronic draining wound on the right ventral thorax. Diagnostics revealed numerous fistulous tracts opening at a single site on the right ventrolateral chest wall, extending caudodorsally through the chest wall and diaphragm to the region of the right medial liver lobe. Exploratory laparotomy revealed the apex of the gallbladder adhered to the diaphragm with a tract of fibrous tissue extending along the diaphragm laterally to the right thoracic wall. Cholecystectomy was performed. The fistulous tract was incised to expose the lumen of the fistula, and the fistula was omentalized. Twenty-eight months after surgery, the dog had had no recurrence of the fistulous tract. Exploratory laparotomy allowed excellent visualization of the intra-abdominal path of the fistula and facilitated the ease of resection of the source. Cholecystectomy resulted in rapid and complete resolution of the fistula without the need for excision of the fistula. Although rare, gallbladder disease should be a differential for chronic fistulous tracts.

Biliothorax in a Siamese cat.

A 2-year-old male neutered cat presented for further investigation of biliothorax. The cat was initially treated for pyothorax, including bilateral chest drains for lavage of the pleural space. Five days later, the pleural effusion turned clear-yellow and had a bilirubin concentration of 427 µmol/l compared to the serum bilirubin concentration of 15 µmol/l. Exploratory surgery revealed a 2mm tear in the diaphragm, with a corresponding 2mm defect in the diaphragmatic surface of the gall bladder, creating a fistula between the gall bladder and the pleural cavity. The defects were repaired routinely and the cat made a full recovery. It was suspected that the tears had been created at the time of the thoracostomy tube placement. Biliothorax has not been described before in a cat, and appears to be a rare complication following thoracostomy tube placement.

Spontaneous external biliary fistula in a dog.

CASE DESCRIPTION: A 10-year-old sexually intact female dog was examined because of a static, well-circumscribed subcutaneous mass and associated fistulous draining tract located along the right ventrolateral aspect of the thoracic body wall of 15 months' duration. CLINICAL FINDINGS: Results of computed tomography and fistulography confirmed the presence of the fistulous tract. Computed tomography also revealed a focal, hypodense region in the right ventral portion of the liver that was adjacent to but not clearly associated with the fistulous tract. TREATMENT AND OUTCOME: Surgical exploration of the tract revealed that it passed into the right hemithorax to the diaphragm; entered the right medial lobe of the liver; and terminated in a well-encapsulated, cystic liver lesion. The right medial liver lobe and all affected tissues were removed. Histologically, the liver lesion consisted of a fibrotic, dilated bile duct. The dilated bile duct and fistula were lined with biliary epithelium. On the basis of these findings, a diagnosis of spontaneous external biliary fistula was made. Five months after surgery, the dog was clinically normal. CLINICAL RELEVANCE: To the authors' knowledge, spontaneous external biliary fistula in a dog has not been reported in the veterinary medical literature. Despite the rarity of this condition, it should be considered in a dog with similar clinical findings. Clinical findings and results of appropriate diagnostic imaging procedures may provide valuable information in making this diagnosis and in planning surgical treatment.

Umbilico-biliary fistula in a dog.

This case report describes a previously unreported congenital malformation, an umbilico-billary fistula, in a dog. A one-year-old male bulldog was diagnosed with umbilico-billary fistula using fistulography. Treatment involving surgical removal of the fistula was straightforward and resulted in clinical resolution of the problem.

Imaging diagnosis: biliopleural fistula in a dog.

A 3-year-old intact male Brittany Spaniel was admitted for thoracic gunshot wounds. Despite continued supportive care, the dog's condition deteriorated. Thoracic/abdominal ultrasound revealed a biliopleural fistula. Following fistula repair, the dog made a complete recovery. This case represented a diagnostic challenge because of the uncommon clinical presentation of a severe bile pleuritis in the absence of significant bile peritonitis. Biliopleural fistula is a rare condition but should be considered as a differential diagnosis in trauma patients with pleural effusion, especially those with penetrating thoracic injuries. Ultrasonography can be used to diagnose this disorder preoperatively.

Diagnosis of a porto-azygous shunt using helical computed tomography angiography.

Congenital portosystemic shunts occur uncommonly in dogs. Conventional diagnostic methods either do not offer simultaneous diagnosis and anatomic characterization or require an invasive selective catheterization. Helical computed tomography (HCT) is a rapid, noninvasive means of acquiring cross-sectional images of any portion of the body. Combined with a peripheral venous injection of contrast medium, HCT can produce computer-rendered, "angiogram-like" images of vasculature. These computer-generated multiplanar and three-dimensional HCT angiographic images were helpful in the diagnosis and accurate anatomic characterization of a porto-azygous shunt. A brief discussion of scanner and contrast medium protocol considerations necessary to achieve adequate vascular opacification for volumetric data reconstructions and diagnosis are outlined.

Chronic bile duct cannulation of rhesus macaques (Macaca mulatta) without causing biliary fistulas.

Two surgical procedures were used for establishing chronic bile duct cannulations in rhesus macaques (Macaca mulatta) while maintaining an intact enterohepatic circulation for use in metabolism studies. One procedure resulted in the formation of biliary fistulas in all of the animals, whereas the other procedure allowed successful maintenance of the macaques without fistulation for up to 8 months after surgery. The possible importance of pressure against bile outflow in the development of the fistulas was discussed.