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PSS…again??

Sonopath Forum

This one I’m not sure. Im kind of excited of a gastrocaval shunt but patient doesnt quite fit. It’s an incidental finding.

-7y old, male intact Dachshund with no much syntomatology. On survey X-rays there is opacity in stomach so scan is arranged to investigate.

This one I’m not sure. Im kind of excited of a gastrocaval shunt but patient doesnt quite fit. It’s an incidental finding.

-7y old, male intact Dachshund with no much syntomatology. On survey X-rays there is opacity in stomach so scan is arranged to investigate.

-US: 3cm FB (pebble stone or seed or similar) in antrum. Has been there for at least 2 weeks. NO VOMITING. Liver appeared small on xrays and on scan (decreased distance from GB to diaprhagm-touching it, from stomach to diaphragm, not so obvious on transverse view), spleen enlarged, no discrete lesions. Kidneys 5cm long (6.4kg dog). No lithiasis/mineralization in kidneys nor bladder. When I saw liver I thought of shunt and went to Caudal vena cava for the search. And this is what I got (FB was not helping)

Any ideas? it appears like a short small shunt…the difference in PV diameter is not dramatic. I know the turbulence in CVC can potentially be hepatic veins…but still, I think it fits more with a shunt location than hepatic veins location.

Bile acids are to be done, but I wanted to check first.

Thanks so much in advance.

Comments

EL

Nope no shunt on this one.

Nope no shunt on this one. Rule of thumb when the PV jumps out its not an EHPSS but still could be an IHPSS but then stand back and put the probe down and look at the patient… poor doer?? bladder sand and stones??? small liver…. hoofsteps + horses before the zebras:) been there belwieve me once you get a shunt then everything colorfule makes us run too far down to the zebra territory. 7 year old Dixoxies on raer occasion have a congential shunt they have lived with, usually and azygos shunt (ggod thought) as those can be later bloomer shunts, but they always have bladder sand and stones and small livers and so forth.

Tough to find the PV and low volume? then look for the shunt. Nice voluminous PV then there will not be an extrahepatic shunt. Nice image set that allows definitive rule out here. See the labeling on my images taken screen shot from videos 2 and 3 that you posted.

Anonymous

Ha!!! Thank you!!! It was
Ha!!! Thank you!!! It was really Not a typical case for shunt. Taking note of all that:) thanks again!