Concomitant, Acquired Cavo‐Azygos Shunt and Spleno‐Gastroepiploic Bypass After Multiple Venous Obstruction in a Dog

ABSTRACT A 13‐year‐old intact female Shih Tzu presented with anorexia, panting and pain of unknown origin. Physical examination was normal except for a systolic murmur (grade 3/6). Abdominal radiographs revealed an ill‐defined area of increased opacity in the mid‐abdomen. A subsequent computed tomog...

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Main Authors: Seul Lee, Hyesun Kim, Kichang Lee, Hakyoung Yoon
Format: Article
Language:English
Published: Wiley 2025-01-01
Series:Veterinary Medicine and Science
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Online Access:https://doi.org/10.1002/vms3.70162
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author Seul Lee
Hyesun Kim
Kichang Lee
Hakyoung Yoon
author_facet Seul Lee
Hyesun Kim
Kichang Lee
Hakyoung Yoon
author_sort Seul Lee
collection DOAJ
description ABSTRACT A 13‐year‐old intact female Shih Tzu presented with anorexia, panting and pain of unknown origin. Physical examination was normal except for a systolic murmur (grade 3/6). Abdominal radiographs revealed an ill‐defined area of increased opacity in the mid‐abdomen. A subsequent computed tomography (CT) scan confirmed a large, heterogeneously enhancing mass near the left adrenal gland, extensively invading the adjacent caudal vena cava, portal vein and splenic vein. This was accompanied by multiple metastatic lesions affecting the abdominal lymph nodes, lungs, liver and kidneys. Two distinct vascular anomalies were identified. The first was a shunt vessel that was diverting pre‐occlusive blood from the caudal vena cava to the azygos vein, causing dilation of the azygos vein and forming a cavo‐azygos shunt. The second was a significantly distended left gastroepiploic vein, forming a collateral pathway that rerouted blood from the splenic vein and ultimately drained into the gastroduodenal and portal vein. These findings are clinically significant as they demonstrate the formation of unique collateral pathways, specifically a cavo‐azygos shunt and spleno‐gastroepiploic bypass, which play a crucial role in maintaining venous drainage and systemic circulation in the presence of multiple venous obstructions. Recognizing such vascular anomalies through advanced imaging techniques like CT provides insights into underlying pathologies and aids in better clinical decision‐making for chronic venous obstructions in veterinary patients.
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spelling doaj-art-91a1c6ecd63e45dc8fe4a1f4ce3964482025-08-20T02:40:41ZengWileyVeterinary Medicine and Science2053-10952025-01-01111n/an/a10.1002/vms3.70162Concomitant, Acquired Cavo‐Azygos Shunt and Spleno‐Gastroepiploic Bypass After Multiple Venous Obstruction in a DogSeul Lee0Hyesun Kim1Kichang Lee2Hakyoung Yoon3Department of Veterinary Medical Imaging College of Veterinary Medicine Jeonbuk National University Iksan Jeollabuk‐do Republic of KoreaV Animal Medical Center Jeju‐si Jeju‐do Republic of KoreaDepartment of Veterinary Medical Imaging College of Veterinary Medicine Jeonbuk National University Iksan Jeollabuk‐do Republic of KoreaDepartment of Veterinary Medical Imaging College of Veterinary Medicine Jeonbuk National University Iksan Jeollabuk‐do Republic of KoreaABSTRACT A 13‐year‐old intact female Shih Tzu presented with anorexia, panting and pain of unknown origin. Physical examination was normal except for a systolic murmur (grade 3/6). Abdominal radiographs revealed an ill‐defined area of increased opacity in the mid‐abdomen. A subsequent computed tomography (CT) scan confirmed a large, heterogeneously enhancing mass near the left adrenal gland, extensively invading the adjacent caudal vena cava, portal vein and splenic vein. This was accompanied by multiple metastatic lesions affecting the abdominal lymph nodes, lungs, liver and kidneys. Two distinct vascular anomalies were identified. The first was a shunt vessel that was diverting pre‐occlusive blood from the caudal vena cava to the azygos vein, causing dilation of the azygos vein and forming a cavo‐azygos shunt. The second was a significantly distended left gastroepiploic vein, forming a collateral pathway that rerouted blood from the splenic vein and ultimately drained into the gastroduodenal and portal vein. These findings are clinically significant as they demonstrate the formation of unique collateral pathways, specifically a cavo‐azygos shunt and spleno‐gastroepiploic bypass, which play a crucial role in maintaining venous drainage and systemic circulation in the presence of multiple venous obstructions. Recognizing such vascular anomalies through advanced imaging techniques like CT provides insights into underlying pathologies and aids in better clinical decision‐making for chronic venous obstructions in veterinary patients.https://doi.org/10.1002/vms3.70162abdominal masscaninecavo‐azygos shuntcollateral vesselscomputed tomography
spellingShingle Seul Lee
Hyesun Kim
Kichang Lee
Hakyoung Yoon
Concomitant, Acquired Cavo‐Azygos Shunt and Spleno‐Gastroepiploic Bypass After Multiple Venous Obstruction in a Dog
Veterinary Medicine and Science
abdominal mass
canine
cavo‐azygos shunt
collateral vessels
computed tomography
title Concomitant, Acquired Cavo‐Azygos Shunt and Spleno‐Gastroepiploic Bypass After Multiple Venous Obstruction in a Dog
title_full Concomitant, Acquired Cavo‐Azygos Shunt and Spleno‐Gastroepiploic Bypass After Multiple Venous Obstruction in a Dog
title_fullStr Concomitant, Acquired Cavo‐Azygos Shunt and Spleno‐Gastroepiploic Bypass After Multiple Venous Obstruction in a Dog
title_full_unstemmed Concomitant, Acquired Cavo‐Azygos Shunt and Spleno‐Gastroepiploic Bypass After Multiple Venous Obstruction in a Dog
title_short Concomitant, Acquired Cavo‐Azygos Shunt and Spleno‐Gastroepiploic Bypass After Multiple Venous Obstruction in a Dog
title_sort concomitant acquired cavo azygos shunt and spleno gastroepiploic bypass after multiple venous obstruction in a dog
topic abdominal mass
canine
cavo‐azygos shunt
collateral vessels
computed tomography
url https://doi.org/10.1002/vms3.70162
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