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chronic diarrhea, prominent portal markings with “bubbles”

11 year old MN Visla with chronic diarrhea and chronic intermittent morning vomiting of bile.  The diarrhea is not responsive to Tylan.  Has been on a grain free diet for 8 years.  The portal markings were the only distinguishable finding on ultrasound.  I have never seen the little bubbles in the portal vessels like you can see in the attached video.  Thoughts? Previous blood work a couple of months ago showed a mild inc. in ALT.  I was assuming the portal markings were reactive to the diarrhea, but became alarmed when I saw the bubbles.  

11 year old MN Visla with chronic diarrhea and chronic intermittent morning vomiting of bile.  The diarrhea is not responsive to Tylan.  Has been on a grain free diet for 8 years.  The portal markings were the only distinguishable finding on ultrasound.  I have never seen the little bubbles in the portal vessels like you can see in the attached video.  Thoughts? Previous blood work a couple of months ago showed a mild inc. in ALT.  I was assuming the portal markings were reactive to the diarrhea, but became alarmed when I saw the bubbles.  

kromero

5 responses to “chronic diarrhea, prominent portal markings with “bubbles””

  1. Not sure those are bubbles..

    Not sure those are bubbles.. Looks like parenchymal mineralization like you see in cushings patients

    • Shoot, maybe they aren’t

      Shoot, maybe they aren’t coming over as prominently, but the vessels litterally have small hyperechoic non shadowing objects shooting through the vessels.  Could that be mineralization? An the hyperechoic areas elsewhere you think are more than just inflammatory changes around portal vessels? Adrenals were not enlarged.  

  2. Are you not just catching

    Are you not just catching blood flow through th vessel at different angles?

     

  3. Had you given any IV

    Had you given any IV injections recently by chance?  I saw a case posted showing bubbles in the liver vasculature after an injection in the lateral saphenous vein…. presumed gas bubbles post-injection?  They were very cool looking!  🙂  -Karen

    • Good thought, but no, this

      Good thought, but no, this was just an outpatient ultrasound.  They were so prominent, my tech noticed them too! Thanks Karen, hope you are well!

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