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病例报告:犬门静脉原发性发育不全所致门静脉高压的成功手术干预。

Case Report: Successful surgical intervention for portal hypertension caused by primary hypoplasia of the portal vein in a dog.

作者信息

Shin Joon-Ho, Han Hyun-Jung

机构信息

Department of Veterinary Emergency and Critical Care Medicine, College of Veterinary Medicine, Konkuk University, Seoul, Republic of Korea.

KU Center for Animal Blood Medical Science, Konkuk University, Seoul, Republic of Korea.

出版信息

Front Vet Sci. 2025 May 27;12:1582290. doi: 10.3389/fvets.2025.1582290. eCollection 2025.

Abstract

An 11-year-old, 5-kg castrated male Miniature Poodle presented with persistent ascites lasting 3 weeks. A thorough physical examination, comprehensive blood tests, and diagnostic imaging (including radiography, ultrasonography, and computed tomography) revealed ascites, splenomegaly, hepatomegaly, and decreased portal vein velocity (5-6.6 cm/s), leading to a diagnosis of portal hypertension. Prehepatic and posthepatic causes were ruled out, and the patient was diagnosed with intrahepatic portal hypertension. Despite conservative management with diuretics and a sodium-restricted diet, severe ascites persisted. A surgical liver biopsy via exploratory laparotomy was performed to determine the specific cause of intrahepatic portal hypertension. Concurrently, splenectomy was carried out after identifying splenomegaly and congestion, which were likely associated with portal hypertension. Histological examination of the spleen revealed mild-to-moderate congestion and complex nodular hyperplasia, while liver examination confirmed a diagnosis of primary hypoplasia of the portal vein (PHPV). Postoperatively, the dog experienced a transient increase in ascites and complications such as anorexia, mild anemia, and hypoalbuminemia, all of which were managed with supportive care. From postoperative day 4, the ascites completely resolved, and the portal vein velocity normalized (17-18 cm/s). Four months post-surgery, the patient showed no further signs of ascites. This case report describes the diagnosis and successful management of PHPV-induced portal hypertension in a dog, highlighting the efficacy of splenectomy in resolving ascites and improving portal vein hemodynamics in cases of PHPV in dogs.

摘要

一只11岁、体重5千克的去势雄性迷你贵宾犬出现持续3周的顽固性腹水。全面的体格检查、综合血液检查以及诊断性影像学检查(包括X线摄影、超声检查和计算机断层扫描)显示有腹水、脾肿大、肝肿大以及门静脉血流速度降低(5 - 6.6厘米/秒),从而诊断为门静脉高压。肝前性和肝后性病因被排除,该患者被诊断为肝内门静脉高压。尽管采用利尿剂和限钠饮食进行保守治疗,严重腹水仍持续存在。通过剖腹探查术进行了手术肝活检,以确定肝内门静脉高压的具体病因。同时,在发现脾肿大和充血(可能与门静脉高压相关)后进行了脾切除术。脾脏组织学检查显示轻度至中度充血和复杂的结节性增生,而肝脏检查确诊为门静脉原发性发育不全(PHPV)。术后,这只狗出现腹水短暂增加以及诸如厌食、轻度贫血和低白蛋白血症等并发症,所有这些均通过支持性护理进行处理。从术后第4天起,腹水完全消退,门静脉血流速度恢复正常(17 - 18厘米/秒)。术后4个月,该患者未再出现腹水迹象。本病例报告描述了犬PHPV所致门静脉高压的诊断及成功治疗,突出了脾切除术在解决犬PHPV病例中的腹水和改善门静脉血流动力学方面的疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/51a2/12150236/5610ca10d70d/fvets-12-1582290-g001.jpg

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