• Title/Summary/Keyword: extrahepatic PSS

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Diagnostic imaging of portosystemic shunts in 43 dogs (개 문맥전신순환단락의 진단영상 43례)

  • Choi, Jihye;Kim, Hyunwook;Jang, Jaeyoung;Kim, Junyoung;Yoon, Junghee
    • Korean Journal of Veterinary Research
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    • v.48 no.2
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    • pp.227-233
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    • 2008
  • Portosystemic shunt (PSS) was diagnosed in 43 dogs by mesenteric portogram from January, 2002 to June 2007 in Haemaru referral animal hospital. PSS was found in various breeds including Maltese, Miniature Schnauzer and Yorkshire Terrier and there was no predisposition in gender. In laboratory parameters, mean cell volume was lower than normal value in single shunt and alanine aminotransferase was higher than normal range in multiple shunts with clinical significance. Cystic calculi were found in over 50% dogs with PSS and even in 70.8% dogs with single shunt. In 81% dogs with PSS, extrahepatic single shunt such as portocarval type and portoazygous type was identified. Extrahepatic multiple shunt and intrahepatic single shunt were observed in 4 dogs, respectively. Gradual attenuation using ameroid constrictor was applied to 35 dogs with extrahepatic single shunt and the prognosis of these dogs were good except two dogs, which showed poor prognosis because of acquired multiple PSS and renal disease unrelated with PSS, respectively.

Imaging diagnosis of extrahepatic biliary tract obstruction with acquired portosystemic shunt in a cat

  • Hwang, Tae-Sung;Jang, Won-Seok;Yoon, Young-Min;Jung, Dong-In;Lee, Hee Chun
    • Korean Journal of Veterinary Research
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    • v.58 no.4
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    • pp.227-230
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    • 2018
  • A 2-year-old, spayed female, Korean domestic short-hair cat was presented with depression and vomiting. The patient had history of weight loss lasting seven months. Physical examination revealed icterus in the pinna, oral mucosa, and sclera. Based on ultrasonography and computed tomography, tentative diagnosis was extrahepatic biliary tract obstruction with acquired portosystemic shunt (PSS). Tumor or inflammation of hepatobiliary system was suspected as the cause of obstruction of the common bile duct. But it could not be determined without biopsy. The severely dilated cystic duct was considered to cause portal hypertension and secondary multiple PSS. The patient expired without histopathologic examination.

Diagnostic Imaging Features of Asymptomatic Extrahepatic Portosystemic Shunt Detected by CT in Dogs (개에서 컴퓨터단층촬영술을 이용하여 진단한 임상증상이 없는 간외성 전신문맥단락의 영상학적 평가)

  • Choi, Soo-Young;Lee, In;Choi, Ho-Jung;Lee, Young-Won
    • Journal of Veterinary Clinics
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    • v.30 no.4
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    • pp.273-277
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    • 2013
  • This study was performed to compare clinical and diagnostic imaging features between asymptomatic and symptomatic extrahepatic portosystemic shunts in dogs. The data of thirty patients diagnosed with extrahepatic PSS by multi-detector CT were reviewed, and the dogs were divided into asymptomatic (9/30) and symptomatic (21/30) groups. Signalments, hematologic results, liver size, morphologic classifications and main portal vein to abdominal aortic ratio (PV/AO) at the porta hepatis level from CT images were evaluated in two groups. Shih-tzu (5/9) was the most frequent breed in asymptomatic group, and various breeds were presented in symptomatic group. Mean age of asymptomatic group ($9.2{\pm}3.2$ years) was significantly higher than that of symptomatic group ($4.5{\pm}3.2$ years). The most morphologic form of shunt vessel was the splenophrenic shunt (16/30). PV/AO of asymptomatic group ($1.1{\pm}0.19$) was significantly higher than the values of symptomatic group ($0.55{\pm}0.19$). Clinical signs, hematologic results and diagnostic imaging findings of asymptomatic PSS are too nonspecific to suspect PSS. Therefore, considering of patient's age and CT examination with application of PV/AO ratio could be useful for the diagnosis of asymptomatic PSS.

Radiographic Liver Size Evaluation after Portosystemic Shunts Ligation in 13 Cases

  • Hong, Sung-kyun;Kim, Hye-jin;Lee, Si-heon;Kim, Wan-hee;Kweon, Oh-kyeong;Jung, Joo-hyun;Yoon, Jung-hee;Choi, Min-cheol
    • Journal of Veterinary Clinics
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    • v.34 no.3
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    • pp.189-192
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    • 2017
  • Thirteen dogs were diagnosed as congenital extrahepatic single PSS by intraoperative mesenteric portovenography or computed tomographic examination, repair surgery was performed by using an ameroid constrictor. Hepatic size was measured from the right lateral view using liver length/T11 length ratio. This measurement was performed on follow-up check of PSS ligation patients. Hepatic size parameter of pre-operative PSS patients is $4.13{\pm}0.13$ (range, 3.11-4.83). After surgery, hepatic size parameter of post-operative PSS patients is $4.79{\pm}0.19$ (range, 3.78- 5.93). Although follow-up periods varied 2 and 26 weeks, all patients showed increased liver size compared to that on pre-operative radiographs (P < 0.01). The increase rate was 1.01-1.46 times than those of preoperative radiographs. But in 5 patients, post hepatic liver size was small compared to the others, which showed low increase rate of body weight, total protein, albumin, and glucose level. It was thought that small value of hepatic size parameter was due to delay of hepatic regeneration. In conclusion, radiographic hepatic size parameter of pre- and post-operative patients is considered an effective evaluation for restoring after PSS surgery.

Acquired Portosystemic Shunts Secondary to Hepatic Microvascular Dysplasia in a Young Dog

  • Hwang, Taesung;An, Soyon;Kim, Ahreum;Han, Changhee;Huh, Chan;Lee, Hee Chun
    • Journal of Veterinary Clinics
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    • v.37 no.2
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    • pp.88-90
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    • 2020
  • A one year old spayed female Bichon Frise dog presented with gait abnormalities and seizure. Serum biochemical results showed elevated levels of alkaline phosphatase, alanine aminotransferase, and ammonia. Serum bile acid level was also increased to be over 30 μmol/L on preprandial. Urinalysis identified the presence of ammonium urate crystal. Abdominal ultrasonography and CT revealed aberrant, tortuous, and multiple small vessels connected to the caudal vena cava between left kidney and caudal vena cava. Macroscopic specific findings associated with extrahepatic congenital portosystemic shunts (PSS) or other liver diseases were not identified. Liver biopsy was performed. Histopathologic evaluation revealed hepatic lobular hypoplasia with portal arterial duplication and vascular shunts. Based on these finding, this case was diagnosed as multiple acquired PSS secondary to hepatic microvascular dysplasia (HMD) and hepatic encephalopathy. A liver biopsy is recommended to differentiate HMD from other liver diseases and to confirm HMD when a young dog has multiple acquired PSS.

Diagnostic Imaging of Portosystemic Shunt using CT in Two Dogs (전산화단층촬영을 이용한 문맥전신단락의 진단 증례)

  • Jung, Joo-Hyun;Chae, Woong-Joo;Chang, Jin-Hwa;Chae, Ho-Cheol;Kim, Wan-Hee;Lee, Ki-Chang;Yoon, Jung-Hee;Choi, Min-Cheol
    • Journal of Veterinary Clinics
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    • v.24 no.3
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    • pp.461-466
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    • 2007
  • Two dogs were admitted with a history of anorexia, ataxia, shivering, lethargy, hypersalivation and seizure. Patients were suspected for portosystemic shunts on the basis of clinical signs, increased hepatic serum profiles on the blood test, microhepatica on plain abdominal radiographs, and an abnormally dilated and tortuous vessel on abdominal ultrasonographs. To diagnose PSS and to further evaluate type, shape, and location of shunt and hepatic vasculatures, the computed tomography (CT) angiography for portal and systemic circulation was performed. The shape, location and pathway of extrahepatic single shunt were confirmed in two dogs. Dual phases (the arterial phase and the venous phase) CT angiography and reformatted and three-dimensional images offered good understanding of PSS and planning surgical treatment.

Single Extrahepatic Portosystemic Shunt in 3 Dogs: CT Findings and Progress (3마리의 개에서 발생한 단일 간외성 문맥전신 단락 증례)

  • Lee, Hee-Chun;Ji, Chang-Moo;Moon, Jong-Hyun;Cho, Kyu-Woan;Kim, Young-Ki;Kang, Byeong-Teck;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.488-493
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    • 2012
  • Two Maltese (2-year-old, intact female and 4-month-old, intact female) and a Pekingese (10-year-old, intact male) dogs were referred due to vomiting, anorexia, head-pressing and hypersalivation. Physical examinations, complete blood count, serum chemical analysis, radiography, ultrasonography and computed tomography (CT) were evaluated. Laboratory findings in these dogs included high hepatic enzyme, serum bile acid and ammonia concentration. Microhepatia was found on abdominal radiographs in two dogs. The existence of portosystemic shunt was presented in abdominal ultrasonography. The shunt vessel was identified in all dogs by CT imaging. Based on three-dimensional CT reconstruction, the origin and termination of each shunt vessel were defined certainly. In consequence, each dog was diagnosed single extrahepatic portosystemic shunt. After diagnosis, surgical treatment was performed in all dogs. This case report describes clinical finding, imaging characteristics, and three-dimensional CT imaging of single extrahepatic portosystemic shunt cases.

Computed tomographic evaluation of portal vein indices in cats with the extrahepatic portosystemic shunts

  • Eunji Jeong;Jin-Young Chung;Jin-Ok Ahn;Hojung Choi;Youngwon Lee;Kija Lee;Sooyoung Choi
    • Journal of Veterinary Science
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    • v.25 no.3
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    • pp.37.1-37.10
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    • 2024
  • Importance: The portal vein to aorta (PV/Ao) ratio is used to assess the clinical significance of extrahepatic portosystemic shunt (EHPSS). Previous studies using computed tomography (CT) were conducted in dogs but not in cats. Objective: This study aimed to establish normal reference values for PV indices (PV/Ao ratio and PV diameter) in cats and determine the usefulness of these for predicting symptomatic EHPSS. Methods: This study included 95 dogs and 114 cats that underwent abdominal CT. The canine normal (CN) group included dogs without EHPSS. The cats were classified into feline normal (FN, 88/114), feline asymptomatic (FA, 16/114), and feline symptomatic (FS, 10/114) groups. The PV and Ao diameters were measured in axial cross-sections. Results: The group FN had a higher PV/Ao ratio than the group CN (p < 0.001). Within the feline groups, the PV indices were in the order FN > FA > FS (both p < 0.001). The mean PV diameter and PV/Ao ratio for group FN were 5.23±0.77 mm and 1.46±0.19, respectively. The cutoff values between groups FN and FS were 4.115 mm for PV diameter (sensitivity, 100%; specificity, 97.7%) and 1.170 for PV/Ao ratio (90%, 92.1%). The cutoff values between group FA and FS were 3.835 mm (90%, 93.8%) and 1.010 (70%, 100%), respectively. Conclusions and Relevance: The results demonstrated significant differences in PV indices between dogs and cats. In cats, the PV/Ao ratio demonstrated high diagnostic performance for symptomatic EHPSS. The PV diameter also performed well, in contrast to dogs.