Department of Veterinary Surgery (Kim H, Kwak, Kim J, Woo) and Department of Veterinary Medical Imaging (Choi), College of Veterinary Medicine & Institute of Veterinary Science, Kangwon National University, 1 Gangwondaehak-gil, Chuncheon-si, Gangwon-do 24341, Korea; Laboratory of Veterinary Surgery and Ophthalmology, College of Veterinary Medicine, Chungbuk National University, 1 Chungdae-ro, Seowon-gu, Cheongju, Chungbuk 28644, Korea (Park).
Can Vet J. 2024 Feb;65(2):119-124.
An 8-month-old female Maltese dog was referred for examination with a history of circling, dullness, and drooling. Serum biochemical analysis revealed hyperammonemia, with microhepatica observed on radiography. Computed tomography angiography revealed a portosystemic shunt originating from the right gastric vein and inserting into the prehepatic caudal vena cava. Portal blood flow to the liver was not observed. Based on computed tomography angiography, the dog was tentatively diagnosed with portosystemic shunt with portal vein aplasia. An exploratory laparotomy was done to obtain a definitive diagnosis. The dog had no subjective clinical signs of portal hypertension during a temporary occlusion test of the portosystemic shunt. A thin-film band was placed around the portosystemic shunt to achieve partial attenuation. There was no evidence of hepatic encephalopathy in the long term after surgery, and the dog's liver volume increased over time. Computed tomography angiography at 6 mo after surgery identified well-visualized intrahepatic portal branches. Key clinical message: We inferred that a direct occlusion test is a reliable diagnostic technique that overcomes the limitations of diagnostic imaging methods, including computed tomography angiography, and is a good technique for determining whether surgical attenuation is possible in dogs with suspected portal vein aplasia.
一只 8 月龄雌性马尔济斯犬因转圈、迟钝和流涎就诊。血清生化分析显示高氨血症，放射影像学检查观察到微肝。计算机断层血管造影显示起源于右胃静脉并插入肝前尾腔静脉的门体分流。未观察到门静脉向肝脏的血流。根据计算机断层血管造影，该犬被初步诊断为门静脉发育不良伴门体分流。进行了剖腹探查以获得明确诊断。在门体分流的临时阻断试验中，该犬没有门静脉高压的主观临床症状。在门体分流周围放置了一条薄膜带以实现部分衰减。手术后长期内没有肝性脑病的证据，并且随着时间的推移，该犬的肝体积增加。手术后 6 个月的计算机断层血管造影显示肝内门静脉分支清晰可见。关键临床信息：我们推断直接阻断试验是一种可靠的诊断技术，克服了包括计算机断层血管造影在内的诊断成像方法的局限性，是确定疑似门静脉发育不良犬是否可以进行手术衰减的良好技术。
