ISSN 2398-2969      

Gallbladder: mucocele

icanis
Contributor(s):

Nick Bexfield

Audrey K Cook

Synonym(s): Mucinous cholecystitis, cystic mucinous hyperplasia of the gallbladder


Introduction

  • A gallbladder mucocele is characterized by the inappropriate accumulation of mucoid material within the gallbladder. This may contain varying proportions of congealed mucus or inspissated bile Gallbladder mucocele 01: outer surface - pathology Gallbladder mucocele 02: inner surface - pathology.
  • This disorder is also referred to as cystic mucinous hyperplasia of the gallbladder or mucinous cholecystitis.
  • Underlying causes are uncertain, but changes in bile composition and /or the function of the gallbladder appear to play crucial roles.
  • Sludging and inspissation of bile may precede the development of a true mucocele, but are routinely noted in healthy dogs and are not directly associated with pathology.
  • Proliferation of the mucin-secreting lining the gallbladder is routinely noted, suggesting that abnormal mucin secretion may occur.
  • Necrosis of the gallbladder wall may occur, presumably due to increased intraluminal pressure.
  • Concurrent endocrinopathies, including diabetes mellitus, hypothyroidism and hyperadrenocorticism may increase the risk of mucocele development.
  • Prevalence:
    • Uncommonly reported prior to the 1990s.
    • Increased prevalence probably associated with advent of abdominal ultrasonography.
    • Over 150 canine cases reported in recent peer-reviewed literature, although this figure will markedly under-estimate the true number of cases seen.
    • Common reason for biliary tract surgery in dogs.

Pathogenesis

Etiology

  • Underlying causes are uncertain, but changes in bile composition and /or the function of the gallbladder appear to play crucial roles.

Predisposing factors

General

Pathophysiology

  • Abnormalities in gallbladder emptying or the composition of the bile itself appear to play a role in the development of a mucocele.
  • Proliferation and dysfunction of mucin-secreting cells in the lining of the gallbladder occurs, possibly in response to exposure to hydrophobic bile salts.
  • Increased mucin content results in thicker bile, with further compromise to gallbladder emptying.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Crews L J, Feeney D A, Jessen C R et al (2009) Clinical, ultrasonographic, and laboratory findings associated with gallbladder disease and rupture in dogs: 45 cases (1997-2007). JAVMA 234 (3), 359-366 PubMed.
  • Walter R, Dunn M E, d'Anjou M A et al (2008) Nonsurgical resolution of gallbladder mucocele in two dogs. JAVMA 232 (11), 1688-1693 PubMed.
  • Aguirre A L, Center S A, Randolph J F et al (2007) Gallbladder disease in Shetland Sheepdogs: 38 cases (1995-2005). JAVMA 231 (1), 79-88 PubMed.
  • Amsellem P M, Seim H B, MacPhail C M et al (2006) Long-term survival and risk factors associated with biliary surgery in dogs: 34 cases (1994-2004). JAVMA 229 (9), 1451-1457 PubMed.
  • Cornejo L, Webster C R L (2005) Canine gallbladder mucoceles. Comp Contin Educ Pract Vet 27 (12), 912-930 VetMedResource.
  • Pike F S, Berg J, King N W et al (2004) Gallbladder mucocele in dogs: 30 cases (2000-2002). JAVMA 224 (10), 1615-1622 PubMed.
  • Worley D R, Hottinger H A, Lawrence H J (2004) Surgical management of gallbladder mucoceles in dogs: 22 cases (1999-2003). JAVMA 225 (9), 1418-1422 PubMed.
  • Besso J G, Wrigley R H, Gliatto J M et al (2000) Ultrasonographic appearance and clinical findings in 14 dogs with gallbladder mucocele. Vet Radiol Ultra 41 (3), 261-271 PubMed.
  • Bromel C, Barthez P Y, Leveille R et al (1998) Prevalence of gallbladder sludge in dogs as assessed by ultrasonography. Vet Radiol Ultra 41 (3), 206-210 PubMed.
  • Newell S M, Selcer B A, Mahaffey M B et al (1995) Gallbladder mucocele causing biliary obstruction in 2 dogs: ultrasonographic, scintigraphic, and pathological findings. JAAHA 31 (6), 467-472 PubMed.

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