Presentation
Presented with decreased appetite, vomiting, and lethargy. The white blood cell count was high, predominently neutrophilia.
Patient Data
On the lateral projections, there is gas superimposed over the liver. The gas bubbles are faintly visible on the v/d projection lateral to the spine. The liver is moderately enlarged. The ascending colon is filled with fecal material, and the descending colon is empty. The remainder of the gastrointestinal tract is normal. No abnormalities are seen in the urinary tract. The spleen is moderately enlarged.
The hepatomegaly with focal gas collection may indicate an inflammatory process such as cholangiohepatitis, or a liver abscess.
The cystic and common bile ducts are mildly thickened and tortuous along their length. Multifocal hyperechoic regions consistent with intraluminal gas are seen throughout these ducts with a few foci also appreciated within the lumen of the pancreatic duct and at one location within the biliary tree within the hepatic parenchyma. The liver is mildly hypoechoic but otherwise within normal limits.
Septic cholangitis with intraluminal gas accumulation of the biliary tree and pancreatic duct. Possible concurrent pancreatitis and/or hepatitis.
Case Discussion
On ultrasound examination, gas was identified in the bile duct and biliary tree. No liver abscesses were identified. The cat improved with medical therapy and the gas began to resolve.
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