References
Abstract
As discussed in part 1 of this series, gallbladder mucocele is defined as a build-up of immobile mucus within the gallbladder that can result in extrahepatic biliary obstruction, pressure necrosis of the gallbladder wall and, ultimately, rupture. Although many gallbladder mucoceles are discovered during abdominal ultrasonography while screening for other diseases, patients with mature gallbladder mucoceles or gallbladder rupture can present as an emergency. Medical management with hepatoprotectants, choleretics, antibiotics and suitable diet can be attempted in certain cases, but cholecystectomy remains the gold standard treatment option. If an underlying cause is detected (such as an endocrinopathy), this should be treated accordingly. Mortality rates following gallbladder removal vary from 16–40%. A high mortality rate has been associated with septic bile peritonitis, hyperadrenocorticism and/or pancreatitis as a concurrent disease.
Part 1 of this 2-part review article discussed the aetiopathogenesis and diagnosing of gallbladder mucoceles (Figure 1). This part will look at treatment options and prognosis.
Although many gallbladder mucoceles are discovered during abdominal ultrasonography while screening for other diseases, patients with mature gallbladder mucoceles or gallbladder rupture can present as an emergency. When a patient, especially one whose breed is genetically predisposed to gallbladder mucoceles, presents with signs of acute abdominal pain, increased body temperature and sometimes icterus, gallbladder mucocele with potential rupture of gallbladder wall should be suspected (Jaffey et al, 2019). The incidence of gallbladder rupture in dogs with gallbladder mucoceles ranges from 20–60% (Pike et al, 2004; Worley et al, 2004).
Peritonitis is an inflammation of the peritoneal cavity and its classification depends on the underlying cause, extent and presence of infectious agents. To help with the diagnosis and classification of peritonitis, cytological, biochemical and microbiological tests should be performed with collected peritoneal effusion sample (Volk, 2015).
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