5-year-old male cat. History of weight loss and vomiting, without loss of appetite. An abdominal ultrasound was performed, revealing a reactive pancreas and free fluid in the abdomen. An abdominal CT scan was performed.
Description
The liver is slightly enlarged, extending caudal to the costal arch, while preserving smooth margins and homogeneous parenchyma, without evidence of nodular or mass-like lesions (pink arrows). The gallbladder is slightly distended, filled with fluid attenuating content, without presence of cholelithiasis. The wall of the gallbladder shows a marked post-contrast enhancement, which also extends along the cystic duct, and common bile duct, all showing a normal size (yellow arrows). The hepatic vascularisation does not show significant abnormalities.
The pancreas is slightly enlarged, especially at the level of its left branch, showing an irregular outline and a mildly heterogenous parenchyma with marked post-contrast enhancement, more prominent in the left pancreatic lobe (orange arrows). The pancreatic duct is minimally distended.
There is a mild/moderate amount of free fluid in the peritoneum, diffusely distributed in the dependent regions and associated with fat stranding (blue arrows).
The hepatic, splenic and, to a lesser extent, jejunal and colic lymph nodes are slightly enlarged with a mildly heterogenous parenchyma (green arrows).
Diagnosis
- Mild diffuse hepatomegaly associated with marked enhancement of the wall of the biliary system. The changes are most likely consistent with cholangiohepatitis (inflammatory or infectious).
- Moderate pancreatic changes, more severe at the left pancreatic lobe, consistent with pancreatitis.
- Mild/moderate peritoneal effusion associated with diffuse mesenteric reaction probably secondary to the processes described.
- Mild multifocal mesenteric lymphadenomegaly (hepatic, splenic, jejunal and colic), consistent with reactive lymphadenopathy.
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