Left lateral liver lobe torsion in a cat with moderate pectus excavatum

Abstract

A 6-year-old neutered female domestic shorthair cat weighing 3.1 kg was referred to the clinic owing to a 2 day history of anorexia. On physical examination, a pectus excavatum (PE) was apparent, and a cranial abdominal mass was palpated. Serum biochemical analysis showed severely elevated liver enzymes. On radiography, the PE was graded as moderate, and a 5 × 3 cm soft tissue density mass was detected in the cranial abdomen. Using duplex ultrasonography, the mass was identified as an enlarged liver lobe with vascular thrombosis. The diagnosis of liver lobe torsion (LLT) was confirmed surgically, and the affected left lateral lobe was resected. On follow-up, performed 1 and 6 months postoperatively, no further abnormalities were found on clinical examination or serum biochemical analysis. At follow-up examination, the PE did not appear to cause any additional clinical signs, indicating that treatment of moderate PE in older animals is not obligatory. This is the first reported case of LLT with concurrent PE, and the second feline case of LLT treated surgically. Animals with anatomical malformation of the diaphragm caused by PE may be at higher risk of developing LLT. Early diagnosis and surgical intervention of LLT can produce a good clinical outcome without further repercussions.

Diagnostic imaging for the assessment of acquired abdominal vascular diseases in small animals: A pictorial review

“…Organ torsion is an acute cause of vascular compromise that shows characteristic imaging features with both ultrasound and MDCT. Torsions of parenchymatous organs have been reported in small animals for the liver, spleen, and pancreas …”

“…Liver lobe torsion involves more frequently the left lateral hepatic lobe, probably due to its large volume, greater mobility, and relative separation from the other lobes …”

“…With this review, the authors will discuss acquired vascular diseases with three main categories: (a) causes and consequences of diseases Torsions of parenchymatous organs have been reported in small animals for the liver, spleen, and pancreas. [34][35][36][37][38][39][40][41][42][43] The twirling of the mesenteric vessels allows the identification of the "whirl sign" or "whirlpool sign" on ultrasound and MDCT, which is a strong indicator of organ torsion (Figure 1). [44][45][46] On MDCT, it is also possible to identify swirling strands of soft tissue and fat attenuations also causing a "whirl sign" and endovascular hyperattenuating material in the twisted splenic vessels in the center of the "whirl sign," consistent with fresh thrombus (Figure 2).…”

Pektus Ekskavatum Hastası Genç ve Yetişkin Kedilerde Cerrahi Tedavi Sonuçları

“…PE has been reported in Bengal, Main Coon, Burmese, domestic shorthair and domestic longhair cats [4,8,14,16,17] . Domestic shorthair and domestic longhair cats are cats of mixed ancestry and thus not belonging to any particular recognised cat breed [18] , in other words cross bred.…”

Two cases of liver lobe torsion in a white‐lipped tamarin (Saguinus labiatus) and an Alaotran gentle lemur (Hapalemur alaotrensis)

“…Liver lobe torsion (LLT) is an uncommon condition of unknown aetiology that has been described in dogs, cats, horses, rabbits, pigs, an Asian short‐clawed otter and in humans . The accessory and left lobes are most frequently involved in animals, whereas in humans the accessory hepatic lobe or a congenitally abnormal lobe is usually affected …”