Gallbladder mucocoele: A review

Abstract

Gallbladder mucocoele (GBM) is an abnormal, intraluminal accumulation of inspissated bile and/or mucous within the gallbladder. Older, small- to medium-breed dogs seem to be predisposed, but no sex predilection has been identified. Clinical signs are often non-specific and include vomiting, lethargy, anorexia, abdominal pain, icterus and polyuria–polydipsia. Results of a complete blood count may be unremarkable, but serum biochemistry usually reveals increased liver enzymes. The ultrasonographic appearance is diagnostic and well described in the literature. Surgical intervention for the treatment of GBM remains the therapeutic gold standard, with short- and long-term survival for biliary surgery being 66%. The worst outcome is seen in those dogs requiring cholecystoenterostomy. With GBM becoming an apparently increasingly common cause of extrahepatic biliary disease in canines, it is essential that clinicians become familiar with the current literature pertaining to this condition. Numerous predisposing factors are highlighted in this review article and the role of certain endocrinopathies (e.g. hyperadrenocorticism and hypothyroidism) in the development of GBM is touched upon. Furthermore, the aetiopathogenesis of this disease is discussed with reference to the latest literature. Cholecystectomy remains the treatment of choice, but other options are considered based on a current literature review.

Presumptive migrating gall bladder mucocoele in two dogs with gall bladder rupture

“…, Smalle et al . ). Although a gradual change from echogenic biliary sludge to stellate and then kiwifruit appearance has been proposed, the exact cause of the formation of GMs remains unknown in dogs (Besso et al .…”

“…, Smalle et al . ). In severe cases, GMs may be associated with the rupture of the GB and subsequent peritonitis, requiring emergency surgical intervention to restore patency of the bile ducts and cholecystectomy (Malek et al .…”

“…Gall bladder (GB) disease is frequently assessed in dogs and has received growing attention (Pike et al 2004, Worley et al 2004, Aguirre et al 2007, Crews et al 2009, Tsukagoshi et al 2012, Malek et al 2013, Cullen et al 2014, Smalle et al 2015, Cook et al 2016. Gall bladder mucocoeles (GMs) are defined as inspissated bile pigment accumulation in the GB that assume an appearance described as resembling a kiwifruit on ultrasound evaluation (Pike et al 2004, Smalle et al 2015. Although a gradual change from echogenic biliary sludge to stellate and then kiwifruit appearance has been proposed, the exact cause of the formation of GMs remains unknown in dogs (Besso et al 2009, Uno et al 2009).…”

“…Although a gradual change from echogenic biliary sludge to stellate and then kiwifruit appearance has been proposed, the exact cause of the formation of GMs remains unknown in dogs (Besso et al 2009, Uno et al 2009). Putative associations of GMs with certain endocrine and metabolic diseases have been suggested (Kook et al 2012, Smalle et al 2015. In severe cases, GMs may be associated with the rupture of the GB and subsequent peritonitis, requiring emergency surgical intervention to restore patency of the bile ducts and cholecystectomy (Malek et al 2013, Smalle et al 2015.…”

“…Putative associations of GMs with certain endocrine and metabolic diseases have been suggested (Kook et al 2012, Smalle et al 2015. In severe cases, GMs may be associated with the rupture of the GB and subsequent peritonitis, requiring emergency surgical intervention to restore patency of the bile ducts and cholecystectomy (Malek et al 2013, Smalle et al 2015. Typically, bile spillage occurs when the GB ruptures (Malek et al 2013), and in some cases, remnants of the GM may be visible as hyperechoic specks representing fragments of the friable disintegrated GM structure (Pike et al 2004, Escobar & Neel 2011.…”