Endoscopic pathology and liver biopsy. A) Grossly distended small intestine in a Russian tortoise ( Testudo horsfieldii ). This herbivorous tortoise was fed dairy products, which resulted in fermentative enteritis (left prefemoral approach). B) Retained, inspissated yolk sac (y) in a juvenile radiated tortoise ( Astrochelys radiata ) that presented for intermittent anorexia and poor growth. Clinicopathology and diagnostic imaging were unremarkable but endoscope-assisted removal proved curative (left prefemoral approach). C) Chronic hepatic fibrosis in a green iguana ( Iguana iguana ) that presented for anorexia and occasional regurgitation. Diagnostic imaging was unremarkable, and the only clinicopathologic abnormality was a mild increase in postprandial bile acids. Endoscopic biopsy confirmed the diagnosis of severe hepatic fibrosis with cholestasis (left lateral coelioscopy). D) Pale liver (l) in an Aldabra tortoise ( Aldabrachelys gigantea ) that presented with intermittent anorexia. All liver parameters were unremarkable, but severe hepatic lipidosis was diagnosed after liver biopsy (left prefemoral approach). E) Diffuse hepatomegaly (l) in a green iguana that presented with lethargy and anorexia. Diagnostic imaging and liver biochemistry were unremarkable; however, moderate leukocytosis, predominantly heterophilia and azurophilia, was evident. Endoscopic liver biopsy confirmed the diagnosis of bacterial hepatitis due to Klebsiella , and appropriate treatment proved curative (left lateral coelioscopy). F) Biopsy from the edge of the chelonian liver (l) using 1.7-mm biopsy forceps (b) (left prefemoral approach).
Courtesy of Dr. Stephen Divers.