Fine D M, Olivier N B, Walshaw R, Schall W D
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing 48824-1314, USA.
J Am Vet Med Assoc. 1998 Mar 15;212(6):835-7.
An 18-month-old dog was examined because of ascites of 1 month's duration. Typical causes of ascites, including hepatic failure, heart failure, and protein-losing enteropathy, were ruled out. The dog's history included being hit by a car 6 months earlier, and the caudal vena cava had an S shape on thoracic radiographs. In addition, the abdominal fluid had a high protein concentration and low cellular content. These findings were all consistent with a diagnosis of postsinusoidal hypertension secondary to obstruction of hepatic venous outflow (Budd-Chiari-like syndrome). During exploratory thoracotomy, the pericardium appeared to have been torn from the heart and was partially wrapped around the caudal vena cava, causing a constriction. The pericardium was removed and the dog recovered without any further complications. Blunt trauma has been previously reported to cause kinking of the caudal vena cava and Budd-Chiari-like syndrome in dogs; but in these dogs, clinical signs of ascites developed a few days to several weeks after the traumatic incident. It appears that, depending on the cause of the hepatic venous outflow obstruction, onset of Budd-Chiari-like syndrome may be delayed for months.
一只18个月大的犬只因持续1个月的腹水接受检查。排除了腹水的典型病因,包括肝功能衰竭、心力衰竭和蛋白丢失性肠病。该犬的病史包括6个月前被汽车撞击,胸部X光片显示尾腔静脉呈S形。此外,腹腔积液蛋白浓度高而细胞含量低。这些发现均符合肝静脉流出道梗阻继发的窦后性高血压(布加综合征样综合征)的诊断。在开胸探查术中,心包似乎已从心脏撕裂并部分包裹在尾腔静脉周围,导致狭窄。切除心包后,该犬康复且未出现任何进一步并发症。钝性创伤此前曾被报道可导致犬尾腔静脉扭结和布加综合征样综合征;但在这些犬中,腹水的临床症状在创伤事件后数天至数周出现。看来,根据肝静脉流出道梗阻的原因,布加综合征样综合征的发病可能会延迟数月。