Ionised hypercalcaemia in a cat with extrahepatic biliary tract obstruction secondary to a bile duct vegetal foreign body.

Autor:	Pichard D; Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de Médecine Interne, Maisons-Alfort, France., Bernard P; Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de Médecine Interne, Maisons-Alfort, France.; Ecole Nationale Vétérinaire de Toulouse, CHUV-Ac, Service de Médecine Interne, Toulouse, France., Fenet M; Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service d'Imagerie Médicale, Maisons-Alfort, France., Garnier P; Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de Chirurgie, Maisons-Alfort, France., Schoffit S; Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de Chirurgie, Maisons-Alfort, France., Manzoni S; Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de Chirurgie, Maisons-Alfort, France., Benchekroun G; Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de Médecine Interne, Maisons-Alfort, France., Manassero M; Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de Chirurgie, Maisons-Alfort, France., Freiche V; Ecole Nationale Vétérinaire d'Alfort, CHUVA, Service de Médecine Interne, Maisons-Alfort, France.
Jazyk:	angličtina
Zdroj:	JFMS open reports [JFMS Open Rep] 2024 Jul 25; Vol. 10 (2), pp. 20551169241258635. Date of Electronic Publication: 2024 Jul 25 (Print Publication: 2024).
DOI:	10.1177/20551169241258635
Abstrakt:	Case Summary: A 10-year-old neutered female domestic shorthair cat was presented to our hospital with a 2-day history of anorexia, vomiting and lethargy. The biochemistry panel revealed increased hepatic enzyme activity and serum amyloid A concentration. Haematological values were within reference intervals. An abdominal ultrasound identified a hyperechoic spindle-shaped structure within the common bile duct and a suspected secondary subobstruction, associated with signs of intra- and extrahepatic biliary tract inflammation. During hospitalisation, the cat developed severe and sustained ionised hypercalcaemia. Exploratory surgery was elected as a result of the lack of clinical improvement, despite supportive treatment and suspected retrograde migration of the spindle-shaped structure. Two grass awns were extracted at the junction of an extrahepatic duct and the common bile duct via choledochotomy using intraoperative ultrasound guidance. A stent was then placed in the bile duct to prevent subsequent bile leakage. Histopathology of the liver revealed a moderate neutrophilic and lymphoplasmacytic inflammation with rare bacterial colonies. Escherichia coli was cultured from a bile sample. No specific cause of hypercalcaemia was identified. The cat recovered uneventfully from surgery. Hepatic enzyme activities and hypercalcaemia progressively decreased within a few weeks after surgery and remained within the reference intervals without treatment. Therefore, hypercalcaemia was suspected to be secondary to a foreign body-related granulomatous reaction. Relevance and Novel Information: To our knowledge, only one other feline case report of biliary tract obstruction secondary to a biliary foreign body has been described in the literature. This is also the first case reporting the use of intraoperative ultrasound to localise a vegetal foreign body within the biliary tract of a cat. This case is also unique because of the onset of hypercalcaemia suspected to be secondary to a foreign body-related granulomatous reaction. Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. (© The Author(s) 2024.)
Databáze:	MEDLINE
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