Splenic & portal vein thrombosis
Case example
Blocked abdominal roads
An 8-year-old, male-castrated Mestizo presented for ongoing lethargy and acute onset of vomiting
CT findings
- Image Set 1: Large, oval filling-defect extends within portal vein on post i.v. contrast administration images, nearly completely occupying its lumen
- Image Set 2: Additional elongated filling-defects extend through multiple splenic veins causing multifocal complete luminal attenuation
- Image 3: Diffuse splenic enlargement with innumerable rounded to amorphous homogenously contrast enhancing areas throughout parenchyma
- Image 4: Abdominal lymph node enlargement with heterogenous contrast enhancement
Conclusions
- Splenic & portal vein thrombosis with complete and near complete luminal stenosis, splenomegaly with parenchymal nodules and moderate abdominal lymph adenomegaly
- Differential diagnosis: Round cell neoplasia — Lymphoma
Take Home
- Other differential diagnoses with venous thromboses include disseminated intravascular coagulopathy, exogenous cortisol therapy/hyperadrenocorticism, pancreatitis, hepatic, immune-mediated disease, protein-losing enteropathy, other round cell neoplasms.
- Multi-phase CT is imaging modality of choice for detecting thromboemboli as luminal filling-defects on post intravenous contrast administration images.
- CT allows for thrombus localization, scrutinization of extension, number, to confirm or refute acquired shunting and for follow-up evaluation.
More information
- »Portal Vein Thrombosis in 33 dogs: 1998-2011«
— Respess et al.., VJ Vet Intern Med; 1012; 26:230-237 - »Calvarial Hyperostosis syndrome in two bullmastiffs«
— MConnell et al., Vet Radiol & Ultrasound 2006; 47(1): 72-77 - »Diagnostic utility of computed tomographic angiography in dogs with portal vein thrombosis«
— Sato et al., J Vet Med Sci 2020; 282(10): 1421-142
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