Hi everyone!
Ive got an interesting case: 21 week old Lhasa Apso with history of chronic diarrhoea and vomiting. Was presented with lethargy, anorexia, poor body condition and an abdomen full of fluid.
Unfortunately there was not much liver left. The portal vein was severely dilated. Turbulence was observed on colour Doppler. My colleague reports hearing a ‘weird’ murmur from the liver. Why is there turbulence seen in to the portal vein? Is this an example of hepatic arteriovenous fistula? What are my other differentials?
Hi everyone!
Ive got an interesting case: 21 week old Lhasa Apso with history of chronic diarrhoea and vomiting. Was presented with lethargy, anorexia, poor body condition and an abdomen full of fluid.
Unfortunately there was not much liver left. The portal vein was severely dilated. Turbulence was observed on colour Doppler. My colleague reports hearing a ‘weird’ murmur from the liver. Why is there turbulence seen in to the portal vein? Is this an example of hepatic arteriovenous fistula? What are my other differentials?
The rest of the organs were fine. There was no urolithiasis, no lymphadenomegaly and the kidneys were normal in size, shape and architecture.
Comments
With that amount of
With that amount of turbulance and the presence of a “murmur” (refered to as systolic bruit) a hepatic arteriovenous fistula would be the most likley etiology. Not sure of any other conditions giving these changes.
That’s really cool. Have
That’s really cool. Have never diagnosed or seen one before! Thank you!
That’s a wild one lookpris!
That’s a wild one lookpris! Yes AV fistula would be my guess but with also chronic liver disease and maybe portal hypertension given the tortuosity of the pv prior to th eportal hilus and minimal liver thats coarse and irregular. Im assuming bile acids were up? regarding our study on pss and ancillary pss signs like swollen kidneys and renal and bladder stones we did not have any av fistulas in our population. ECVIM 2010
http://www.sonopath.com/resources/research-publications
Interesting case thx for posting and beautiful images. Let ius know if you happen to get bx.
That’s a wild one lookpris!
That’s a wild one lookpris! Yes AV fistula would be my guess but with also chronic liver disease and maybe portal hypertension given the tortuosity of the pv prior to th eportal hilus and minimal liver thats coarse and irregular. Im assuming bile acids were up? regarding our study on pss and ancillary pss signs like swollen kidneys and renal and bladder stones we did not have any av fistulas in our population. ECVIM 2010
http://www.sonopath.com/resources/research-publications
Interesting case thx for posting and beautiful images. Let us know if you happen to get bx.
Hi everyone, Dog went for a
Hi everyone, Dog went for a CT scan and confirmed AV fistula. Dog going into surgery:)
Thanks for all your help!