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Peer-reviewed veterinary case report

Computed Tomography Angiography Diagnosis of a Congenital Intrahepatic Central Divisional Portocaval Shunt in an Arabian Filly.

Journal:
Veterinary radiology & ultrasound : the official journal of the American College of Veterinary Radiology and the International Veterinary Radiology Association
Year:
2025
Authors:
Cournoyer, Nick et al.
Affiliation:
Department of Veterinary Clinical Sciences · United States
Species:
horse

Plain-English summary

A 1-month-old Arabian filly was brought in because she was showing signs of central nervous system problems shortly after she was born. Tests showed she had high levels of ammonia and bile acids in her blood, which led to further imaging of her abdomen using a special type of scan called computed tomography angiography (CTA). This scan found an unusual blood vessel that was causing a connection between her liver and a major vein, along with signs of liver and kidney enlargement. A thorough examination after her passing confirmed that she had a congenital (present at birth) condition known as an intrahepatic portocaval shunt, which is a type of abnormal blood flow in the liver. This case is significant because it shows that CTA can effectively diagnose this condition in young foals.

Abstract

A 1-month-old Arabian filly presented for central neurologic signs that developed shortly after birth. Hyperammonemia and elevated bile acids were identified, prompting abdominal computed tomography angiography (CTA) evaluation on suspicion of congenital portosystemic shunting (PSS). CTA revealed an anomalous vessel connecting the intrahepatic central divisional portal branch and caudal vena cava, with microhepatica and bilateral renomegaly. Necropsy confirmed a single, congenital, and intrahepatic central divisional portocaval shunt. Imaging literature addressing PSS in foals is sparse, with the current case representing the first instance in which CTA alone was fully diagnostic of an intrahepatic shunt in a foal.

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Original publication: https://pubmed.ncbi.nlm.nih.gov/40996890/