Common bile duct obstruction palliated with common bile duct re-implantation (choledochoduodenostomy) in a cat.

A cat was presented with complete biliary obstruction at the level of the distal common bile duct (CBD), with loss of normal architecture. The area was excised and submitted for histopathology. Concurrent cholecystitis and gall bladder necrosis necessitated cholecystectomy. The proximal CBD was preserved and re-implanted adjacent to the original duodenal papilla. The cat recovered and remained asymptomatic for 6 months. At clinical relapse a carcinoma of suspected biliary origin was confirmed, and the cat was euthanized. In situations in which the CBD lumen cannot be re-established, the pathology is limited to the distal CBD, and the gall bladder is not available for cholecystoenterostomy, CBD re-implantation may be an option to salvage and retain a functional biliary tree.

Remédiation d'une obstruction du canal cholédoque par réimplantation du canal cholédoque (cholédochoduodenostomie) chez un chat. Un chat fut présenté avec une obstruction biliaire complète au niveau du canal cholédoque distal (CBD), avec perte de l'architecture normale. La région a été excisée et soumise pour examen histopathologique. Une cholécystite concomitante et une nécrose de la vésicule biliaire ont nécessité une cholécystectomie. Le CBD proximal fut préservé et réimplanté de manière adjacente à la papille duodénale originale. Le chat a récupéré et est demeuré asymptomatique pendant 6 mois. Lors d'une rechute clinique une suspicion de carcinome d'origine biliaire fut confirmée, et le chat euthanasié. Dans des situations où la lumière du CBD ne peut être ré-établie, que la pathologie est limitée au CBD distal, et que la vésicule biliaire n'est pas disponible pour une cholécystoenterostomie, la réimplantation du CBD peut être une option pour sauvegarder et maintenir un système biliaire fonctionnel.(Traduit par Dr Serge Messier).

Extraskeletal osteosarcoma in the duodenum of a cat.

A three-year-old, male neutered domestic longhair cat was referred for evaluation of icterus, vomiting, and anorexia. Abdominal ultrasonography revealed a proximal duodenal mass obstructing the common bile duct. The mass was surgically resected, and a cholecystoduodenostomy was performed. The histopathological diagnosis was osteosarcoma. Thoracic radiographs showed no evidence of metastasis, and bone scintigraphy revealed no signs of a primary skeletal osteosarcoma. Four months after surgery, the cat had intermittent vomiting, marked weight loss, and died.

Surgical treatment of perforating duodenal ulcer in a dog by use of modified choledochoduodenostomy and gastrojejunostomy.

Modified choledochoduodenostomy and gastrojejunostomy were used successfully to treat extensive duodenal ulceration and perforation in a dog. Concomitant pyometra, simultaneously managed by ovariohysterectomy, may have predisposed the dog to stress ulceration. Choledochoduodenostomy was performed by transplantation of the entire common bile duct and associated major duodenal papilla to a more distal duodenal location. An indwelling choledochostomy tube was used to stent the anastomotic site, externally divert bile flow, and allow postoperative cholangiography. Early postoperative complications included presumed metronidazole-induced neurotoxicosis, choledochostomy tube obstruction, and pancreatitis, all of which resolved within 2 weeks. The dog was clinically normal and medication (ranitidine and sucralfate) was discontinued 35 months later.