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Liver dz ddx

Sonopath Forum

– 9 year old very deep chested MN lab x presented for a fairly acute onset of lethargy, abdominal discomfort and distension, pu/pd

– bloodwork 2 x’s elevated ALT, elevated GGT, thrombocytopenia, anemia, TP low,  albumin normal IDEXX 4Dx Neg, Lepto PCR Neg

– u/s showed midly echogenic abdominal effusion, irregular liver capsule with at least two liver masses seen in the right and left liver lobes; spleen was normal

– 9 year old very deep chested MN lab x presented for a fairly acute onset of lethargy, abdominal discomfort and distension, pu/pd

– bloodwork 2 x’s elevated ALT, elevated GGT, thrombocytopenia, anemia, TP low,  albumin normal IDEXX 4Dx Neg, Lepto PCR Neg

– u/s showed midly echogenic abdominal effusion, irregular liver capsule with at least two liver masses seen in the right and left liver lobes; spleen was normal

– owner did not allow sampling of the abdominal fluid so I am left guessing what may be going on in this case (bleeding, transudate etc.?) however my gut feeling is that this is likley hemorrhage from the presentation and blood work

DDx: hepatic hemangiosaroma, lymphoma, carcinoma, cirrhosis, benign hyperplasia (very unlkely)

The lesion in the clip that I took from the right intercostal approach is interesting. I am having a hard time determining if this is a cavitated mass in the liver, in the surrounding fat, strange view of the GB? Any thoughts – I have seen omental hemangio in the past?

Comments

rlobetti

With the history, anemia, low

With the history, anemia, low TP, ascites, and US, the most likley etiology would be ruptured hemangiosarcoma with what looks like an omental mass, and most probably a metastatic lesion.

Pankatz

Thank-you Remo!

Thank-you Remo!