White Bile in Malignant Biliary Obstruction: A Poor Prognostic Marker

Gremida, Anas; Rustagi, Tarun

doi:10.5946/ce.2017.111

Cited by 8 publications

(6 citation statements)

References 3 publications

(3 reference statements)

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“…In line with the presented scenario, excessively high intrabiliary pressure levels in conjunction with continuous mucus secretion by biliary epithelium may, in addition, reverse bile flow into lymphatics and/or the liver [2]. Finally, albeit unproven, "white" or rather "clear bile" is considered particularly prone to infectious complications due to reduced antimicrobial capacities [3].…”

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confidence: 69%

White (or rather clear) bile related to papillary stone impaction

Zimmer

2019

Endoscopy

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confidence: 69%

White (or rather clear) bile related to papillary stone impaction

Zimmer

2019

Endoscopy

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“…All of these pathologies except for gallbladder wall edema are associated with cholestasis or dysfunction of the gallbladder, which may alter the gallbladder resorption of bile salts and compounds that promote stone formation. 16,19 The presence of this material in dogs with gallbladder wall edema is likely due to this pathology's common association with other gallbladder pathologies like cholecystitis and gallbladder mucocele. As compared to the previously reported distribution of mineral material in dogs with gallbladder mucoceles where 67% had in a central location, 12 none of our dogs with a gallbladder mucocele had this distribution.…”

Section: Discussionmentioning

confidence: 99%

Computed tomographic features of confirmed gallbladder pathology in 34 dogs

Brand

Lim

Heng

et al. 2020

Vet Radiology Ultrasound

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Gallbladder pathology is common in dogs, but published studies describing the computed tomographic (CT) appearance of many gallbladder pathologies are currently lacking. This retrospective, multicenter, cases series, descriptive study evaluated the CT features of confirmed gallbladder pathology in 34 dogs. In this subset of dogs, the most common pathologies included cystic mucosal hyperplasia (15/34, 44.1%), gallbladder wall edema (9/34, 26.5%), gallbladder mucocele (8/34, 23.5%), bactibilia (7/34, 20.6%), cholecystitis (6/34, 17.6%), white bile (6/34, 17.6%), and cholelithiasis (4/34, 11.8%). The presence of intraluminal nodules, gallbladder wall thickening, hyperattenuating material (35-100 HU), and mineral attenuating material (>100 HU) were the most common abnormalities detected. However, overlap of each of these findings with a variety of gallbladder pathologies showed that none of the findings were pathognomonic for any of these pathologies. The presence of any of these CT abnormalities should increase the suspicion of gallbladder pathology and prompt further evaluation of the gallbladder for definitive diagnosis.

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“…White bile syndrome has been reported in patients with extrahepatic bile duct obstruction, in which the biliary epithelium continues to secrete mucus despite stagnant bile flow, due to an obstruction at the level of the cystic duct. 20,21 In humans, the presence of white bile has been associated with a shorter survival time for patients with malignant jaundice. 22 While mucoceles are rarely reported in cats, 23–25 early mucocele formation causing a biliary obstruction may have led to cholestasis and opportunistic invasion of Candida species from the intestinal tract in the patient reported here.…”

Section: Discussionmentioning

confidence: 99%

“…White bile syndrome has been reported in patients with extrahepatic bile duct obstruction, in which the biliary epithelium continues to secrete mucus despite stagnant bile flow, due to an obstruction at the level of the cystic duct. 20,21 In humans, the presence of white bile has been associated Figure 4 Representative image from a fine-needle aspirate of the liver. Hepatocytes and increased numbers of nondegenerate neutrophils are caught up within loose streams and tight spirals of pale-to-dark-blue mucinous material.…”

Section: Discussionmentioning

confidence: 99%

Candida albicanscholecystitis with associated hepatitis in a cat

Palermo¹,

Newman

Koch³

2019

Journal of Feline Medicine and Surgery Open Reports

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Case summary A 3-year-old male neutered domestic shorthair cat was presented for vomiting, inappetence and icterus. Biochemical results and ultrasonographic findings were consistent with cholestasis and possible biliary obstruction. A diagnosis of Candida albicans cholecystitis with associated hepatitis was made following cytologic examination and fungal culture. Progressive hyperbilirubinemia and hepatic encephalopathy were ultimately fatal. Relevance and novel information To our knowledge, this is the first report of biliary candidiasis diagnosed by cytologic examination of a cholecystocentesis sample in a domestic animal with no evidence of immunodeficiency. Additionally, this is the first reported case of fungal cholecystitis with associated white bile syndrome due to obstructive cholestasis, without an overt gall bladder mucocele.

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White Bile in Malignant Biliary Obstruction: A Poor Prognostic Marker

Cited by 8 publications

References 3 publications

White (or rather clear) bile related to papillary stone impaction

White (or rather clear) bile related to papillary stone impaction

Computed tomographic features of confirmed gallbladder pathology in 34 dogs

Candida albicanscholecystitis with associated hepatitis in a cat

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