Bae Sohee, Culp William T N, Zwingenberger Allison L
William R. Pritchard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California-Davis, Davis, CA.
Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California-Davis, Davis, CA.
Am J Vet Res. 2025 Jul 31:1-6. doi: 10.2460/ajvr.25.04.0146.
To evaluate the clinical outcomes of dogs with a single congenital extrahepatic portosystemic shunt (EHPSS), in which portal vein atresia (PVA) was considered a differential diagnosis based on CT angiography (CTA), and that underwent surgical exploration.
Medical records were retrospectively reviewed for dogs with a single congenital EHPSS and absent portal vein branches on CTA. Data collected included signalment, clinical signs, preoperative and postoperative clinicopathologic values, diagnostic imaging findings, surgical details, and short- and long-term postoperative follow-up information.
7 client-owned dogs diagnosed with congenital EHPSS and suspected portal vein atresia on CTA that underwent surgical exploration at the William R. Pritchard Veterinary Medical Teaching Hospital at the University of California-Davis from 2010 to 2022 were identified. Surgical attenuation of the EHPSS was successfully performed in 6 of 7 dogs. Intraoperative mesenteric portovenography (IOMP) and/or clinical indicators (eg, absence of visceral congestion) were used to determine suitability for attenuation. In 2 dogs, IOMP was performed, which revealed intrahepatic portal vasculature only after temporary EHPSS occlusion. Postoperative clinicopathologic values and clinical signs were favorable in all 6 dogs that underwent attenuation, with no long-term complications reported. The numeric scoring scale applied to CTA did not appear to influence intraoperative decision-making.
Surgical attenuation of EHPSS in dogs with absent portal branches on CTA may be associated with favorable long-term follow-up, when supported by intraoperative findings.
These findings highlight the limitations of CTA alone in preoperative decision-making for these complex cases and support the use of dynamic evaluation, such as IOMP, in guiding treatment strategies.
评估患有单一先天性肝外门体分流（EHPSS）的犬的临床结局，其中基于CT血管造影（CTA）将门静脉闭锁（PVA）视为鉴别诊断，并对这些犬进行手术探查。
对患有单一先天性EHPSS且CTA显示门静脉分支缺失的犬的病历进行回顾性研究。收集的数据包括特征、临床症状、术前和术后临床病理值、诊断性影像学检查结果、手术细节以及术后短期和长期随访信息。
确定了7只客户拥有的犬，它们在2010年至2022年期间于加利福尼亚大学戴维斯分校的威廉·R·普里查德兽医医学教学医院被诊断为先天性EHPSS且CTA怀疑门静脉闭锁，并接受了手术探查。7只犬中有6只成功进行了EHPSS减状手术。术中肠系膜门静脉造影（IOMP）和/或临床指标（如无内脏充血）用于确定是否适合进行减状手术。2只犬进行了IOMP，结果显示仅在临时阻断EHPSS后门静脉内有肝内血管系统。所有6只接受减状手术的犬术后临床病理值和临床症状均良好，未报告长期并发症。应用于CTA的数字评分量表似乎未影响术中决策。
当有术中发现支持时，对CTA显示门静脉分支缺失的犬进行EHPSS减状手术可能与良好的长期随访结果相关。
这些发现突出了仅依靠CTA在这些复杂病例术前决策中的局限性，并支持使用动态评估，如IOMP，来指导治疗策略。
