PMC9893371_01
Intraoperative photograph: note the absence of the gallbladder around the
gallbladder fossa (circle)
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No gallbladder structures or ectopic gallbladder were visualised around the gallbladder fossa (Figure 1).
Rupture site (arrow) and dilated region (arrowhead) of the common bile duct
(CBD). The duodenum is indicated by the asterisk. The incision at the
dilated CBD had already been closed with a simple interrupted suture pattern
using 7-0 polydioxanone
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The rupture site and the incision in the dilated CBD were closed in a simple interrupted suture pattern with 4-0 polydioxanone (Monodiox; Alfresa Pharma) and 7-0 polydioxanone (PDSII; Ethicon) (Figure 2).
(a) Three-dimensional volume-rendered CT images from CT cholangiography 45
mins after contrast injection. Note that the gallbladder was absent. (b)
Enlarged view of the white square area. The common bile duct (white arrow),
two cystic dilations at the ends of the cystic ducts (arrowheads), and
hepatic ducts (yellow arrows) were well visualised
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The biliary ducts were well visualised at 45 mins after contrast injection, revealing intrahepatic ducts, three hepatic ducts and the CBD, but no gallbladder was visualised in the gallbladder fossa (Figure 3).
Diagram of the biliary tree in this cat. CBD = common bile duct; HD = hepatic
duct; DUO = duodenum
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A diagram of the biliary tree of the case is shown in Figure 4.
Transverse CT from CT cholangiography at (a) 45 mins and (b) 60 mins. Note
the difference of contrast enhancement in intrahepatic bile ducts at 45 mins
(blue arrows) vs 60 mins after contrast injection (yellow arrows)
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At 60 mins, more contrast medium was excreted into the duodenum, resulting in insufficient contrast enhancement in the intrahepatic bile ducts (Figure 5).