Mural gallbladder haematoma in a Parson Russell Terrier

Mural gallbladder haematomas are rare and can occur secondary to trauma, neoplasia, coagulopathies, vascular malformations and other medical aetiologies. This report describes a 5-year-old Parson Russell Terrier that presented with acute vomiting, diarrhoea, inappetence and lethargy. Examination revealed mild icterus and abdominal pain. Serum biochemistry showed a marked biochemical cholangiohepatopathy. Abdominal ultrasound revealed marked thickening of the gallbladder wall that was asymmetrical and diffuse, an immobile hyperechoic intraluminal margin following the wall thickening, minimal intraluminal mobile content, dilation of the common bile duct, minimal peritoneal effusion and mild focal peritonitis. The interpretation was a suspected atypical biliary mucocele with possible gallbladder wall rupture or impending rupture. Exploratory coeliotomy revealed a large, discoloured, inexpressible gallbladder. The biochemical and gross findings were supportive of biliary stasis. A cholecystectomy was performed and histopathology of the gallbladder was consistent with a mural gallbladder haematoma. This case highlights the difficulty of preoperative diagnosis of gallbladder haematomas and reinforces the importance of considering a haematoma as a differential for mural echogenic gallbladder lesions.