Case Report of Congenital Hepatic Arteriovenous Fistula Treated with Liver Lobectomy and Graded Attenuation of Multiple Acquired Portosystemic Shunts in a Dog

Koide, Kazuyoshi; Koide, Yukiko; Asaeda, Hideki; Yabuki, Jun; Yamane, Yoshihisa

doi:10.12935/jvma.66.257

Cited by 1 publication

(1 citation statement)

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“…This is similar to cases in dogs that have undergone hepatic lobectomy that have not exhibited major reductions in portal venous pressure immediately after lobectomy. 18 This suggests that closure of the IHAPF, the origin of the disease itself, does not immediately lead to a drop in portal venous pressure. Increased retrograde hepatofugal flow may be related to histological findings, including fibrosis of the hepatic parenchyma at the IHAPF and hypoplasia of the intrahepatic portal vein.…”

Section: Discussionmentioning

confidence: 99%

Hybrid technique coil embolisation for intrahepatic arterioportal fistula in a cat: case report

Uemura

Haruyama²,

Nakata

et al. 2016

Journal of Feline Medicine and Surgery Open Reports

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Case summaryA 13-month-old, female, mixed breed, 4.0 kg cat was referred with a 6 month history of decreased appetite, loss of vigour and intermittent vomiting. Physical examination revealed no cyanosis or wasting, and no audible heart murmur was auscultated. Blood profile revealed mild anaemia and mildly elevated postprandial serum ammonia (109 µg/dl). Abdominal ultrasonography revealed dilation of an intrahepatic portal vein branch and an intrahepatic aneurysm, with splenomegaly and ascites. Hepatic arteriovenous fistula/hepatic artery–portal vein fistula with multiple acquired portosystemic shunts was strongly suspected. Medical control was achieved using antibiotics, liver-protecting agents, a low-protein diet and blood transfusions. However, because medical treatment proved ineffective, coil embolisation was performed on day 11, using a hybrid approach via the mesenteric vein. Subsequent follow-up showed good appetite, with no signs of diarrhoea or ascites. Abdominal ultrasonography revealed that the mosaic pattern around the site of coil placement in the portal vein branch had improved and pulsatility had disappeared.Relevance and novel informationIntrahepatic arterioportal fistula involves a circulatory shunt between the hepatic artery and the hepatic or portal vein within the liver, and may be congenital or acquired. Both forms have been reported in humans, but most cases in cats have been congenital. Few reports have described treatment methods or prognosis in cats. We report here that coil embolisation using a hybrid approach is a procedure offering easy, effective treatment by blocking hepatofugal blood flow.

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Section: Discussionmentioning

confidence: 99%