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Right gastric vein shunt?

Sonopath Forum

Sonopath Forum

Right gastric vein shunt?

  • Undefined, 14 years, female, castrated

  • Clinical Manifestations of hyperadrenocorticism

  • Bilateral adrenomegaly

  • Structure in the wall of the stomach

  • Hyperechoic liver 

Sorry for the amount of videos, I’m having difficulty exporting images by GE Logiq V2 (they are in miniature)…

 

Regards,

Adams.

  • Undefined, 14 years, female, castrated

  • Clinical Manifestations of hyperadrenocorticism

  • Bilateral adrenomegaly

  • Structure in the wall of the stomach

  • Hyperechoic liver 

Sorry for the amount of videos, I’m having difficulty exporting images by GE Logiq V2 (they are in miniature)…

 

Regards,

Adams.

Comments

EL
December 24, 2017 at 10:38 am -

This tortuous vessel in

This tortuous vessel in intrahepatic in the left liver which has chronic disease. Likely a secondary shunt form chronic hepatic disease. I would do a bile acids and work up the liver. The gastric wall looks chronic inflammatory as well.

gadams
December 24, 2017 at 2:48 pm -

Thanks for the enlightenment

Thanks for the enlightenment Eric! 

As you are an adrenal lover, there goes:

Both are increased, this may be compatible with pituitary-dependent hyperadrenocorticism, right? What worries me is this amorphous and hyperechogenic region in the left adrenal gland.

 ps: the dog weighs no more than 10 kilos (22 lb i think).

Thanks again Eric, Merry Christmas!

 

Best regards,

Adams.

EL
December 24, 2017 at 5:28 pm -

Yep those are biggies… be

Yep those are biggies… be sure to get a blood pressure if you havent already. That hypoerechoic region is likley a lipogranuloma common in hyperplastic adrenals. I would just rescan both adrenals in a month after you have worked them up further. If maybe thinking pheo in the first image run a urine catecholamine if possible. Marshfield labs does it here in the USA.

randyhermandvm
December 25, 2017 at 1:36 pm -

I am not certain the

I am not certain the gallbladder looks all that healthy either. Any chance of an early mucocele and not just sludge? What are we seeing in the stomach?

 

 

gadams
December 26, 2017 at 1:08 am -

The gallbladder

The gallbladder looks chronically inflamed, with the fibrous walls maybe, what do you think Randy? The sludge was well mobile during the examination, with no sign of mucocele, but this region of the stomach made me curious, I do not know what it can be, the patient does not present nausea or vomiting for the time being.

EL
December 26, 2017 at 5:16 pm -

From these viuews th eGb

From these viuews th eGb looks like a typical old fiorbrosed wall and excessive debris but not mucocele at this point but angles can change everything. SDEP abdomen positions 12-14 are best to evaluate the GB and if its really aoverdistended or mucocele like as well as define the cbd and cd.

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