Primary splenic torsion in dogs: 102 cases (1992–2014)

DeGroot, Whitney; Giuffrida, Michelle A.; Rubin, J L; Runge, Jeffrey J.; Zide, Amy; Mayhew, Philipp D.; Culp, William T. N.; Mankin, Kelley Thieman; Amsellem, Pierre M.; Petrukovich, Brandi; Ringwood, P. Brendon; Case, J. Brad; Singh, Ameet

doi:10.2460/javma.248.6.661

Cited by 26 publications

(38 citation statements)

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“…One examination had a free fluid with an attenuation value of 4.4 HU, this was consistent with a less cellular/protein rich fluid . Splenic torsion with abdominal effusion other than hemorrhage has been previously documented . Splenic lymphadenomegaly did not appear to be associated with splenic torsion, as the majority measured within normal limits similar to previously published data .…”

Section: Discussionsupporting

confidence: 82%

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CT characteristics of primary splenic torsion in eight dogs

Hughes

Johnson²,

Genain

2020

Vet Radiology Ultrasound

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Splenic torsion is a rare potentially life‐threatening condition characterized by rotation of the spleen around the gastrosplenic and phrenosplenic ligaments leading to occlusion of venous drainage and arterial supply. This retrospective study describes the CT characteristics for dogs with surgically confirmed splenic torsion from 2013 to 2018 using the submissions to a large multinational teleradiology database. Eight dogs had the splenic torsion confirmed with surgery. Seven of eight cases had histology confirming congestion, hemorrhage, and necrosis, and one had concurrent myelolipoma infiltration. The CT characteristics included an enlarged (8/8), rounded (7/8), folded C‐shaped spleen (8/8) with a difference of median parenchymal attenuation between pre‐ and postcontrast of +1.15 HU (Hounsfield units). Other common features included a mainly homogeneous parenchyma on pre‐ and post‐contrast images (6/8), lack of subjective and objective vascular and parenchymal contrast enhancement (6/8) and free peritoneal fluid (6/8). A “whirl sign” was seen in the majority of cases (7/8) alongside a strongly hyperattenuating center (95‐416 HU) on the precontrast images (5/7), which has not been previously described in the veterinary literature. Gastric position was normal in all cases. More variable CT characteristics of the confirmed torsions were attributable to suspected partial torsion and myelolipomatous infiltration. Overall, primary splenic torsion confirmed with surgery showed consistent characteristics on CT.

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Section: Discussionsupporting

confidence: 82%

“…The resultant vascular occlusion can lead to thrombosis, congestion, and ultimately ischemic necrosis of the spleen . Splenic torsion is often seen in conjunction with gastric dilation and volvulus, but also as an isolated entity . Overall, it accounts for 0.5‐3.4% of all splenic conditions according to previous studies …”

Section: Introductionmentioning

confidence: 98%

CT characteristics of primary splenic torsion in eight dogs

Hughes

Johnson²,

Genain

2020

Vet Radiology Ultrasound

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“…In this case, the authors considered that both conditions might have triggered splenitis because of altered vascularity and blood supply or activation of the reticuloendothelial system. The etiology of primary splenic torsion (PST) and the association between PST and GDV is unclear, with anecdotal evidence suggesting that dogs with history of PST have an increased risk of developing GDV [50]. Based on the former information, we hypothesize that in the dog of the present study splenic changes associated with VBP infection could have induced PST, and potentially secondary GDV.…”

Section: Discussionmentioning

confidence: 82%

Molecular detection of vector-borne pathogens in blood and splenic samples from dogs with splenic disease

et al. 2017

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BackgroundThe spleen is a highly perfused organ involved in the immunological control and elimination of vector-borne pathogens (VBP), which could have a fundamental role in the pathogenesis of splenic disease. This study aimed to evaluate certain VBP in samples from dogs with splenic lesions.MethodsSeventy-seven EDTA-blood and 64 splenic tissue samples were collected from 78 dogs with splenic disease in a Mediterranean area. Babesia spp., Bartonella spp., Ehrlichia/Anaplasma spp., Hepatozoon canis, Leishmania infantum, hemotropic Mycoplasma spp. and Rickettsia spp. were targeted using PCR assays. Sixty EDTA-blood samples from dogs without evidence of splenic lesions were included as a control group.ResultsMore than half (51.56%) of the biopsies (33/64) were consistent with benign lesions and 48.43% (31/64) with malignancy, mostly hemangiosarcoma (25/31). PCR yielded positive results in 13 dogs with spleen alterations (16.67%), for Babesia canis (n = 3), Babesia gibsoni (n = 2), hemotropic Mycoplasma spp. (n = 2), Rickettsia massiliae (n = 1) and “Babesia vulpes” (n = 1), in blood; and for B. canis, B. gibsoni, Ehrlichia canis and L. infantum (n = 1 each), in spleen. Two control dogs (3.3%) were positive for B. gibsoni and H. canis (n = 1 each). Benign lesions were detected in the 61.54% of infected dogs (8/13); the remaining 38.46% were diagnosed with malignancies (5/13). Infection was significantly associated to the presence of splenic disease (P = 0.013). There was no difference in the prevalence of infection between dogs with benign and malignant splenic lesions (P = 0.69); however B. canis was more prevalent in dogs with hemangiosarcoma (P = 0.006).ConclusionsVBP infection could be involved in the pathogenesis of splenic disease. The immunological role of the spleen could predispose to alterations of this organ in infected dogs. Interestingly, all dogs with B. canis infection were diagnosed with hemangiosarcoma in the present survey. As previously reported, results support that VBP diagnosis could be improved by analysis of samples from different tissues. The sample size included here warrants further investigation.Electronic supplementary materialThe online version of this article (doi:10.1186/s13071-017-2074-z) contains supplementary material, which is available to authorized users.

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“…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 …”

Section: Causes Of Vascular Occlusion: Organ Torsion and Thrombosismentioning

confidence: 99%

“…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).…”

Section: Introductionmentioning

confidence: 99%

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

Specchi

d’Anjou

2019

Vet Radiology Ultrasound

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Advances in interventional radiology and surgical techniques now allow complex abdominal diseases to be more successfully treated in small animals. Abdominal vascular alterations, acquired as individual process or as complication of other lesions such as neoplasia, can be life‐threatening or at least greatly limit curative interventions of underlying diseases. Computed tomography (CT) and high‐definition ultrasonography are now readily available in veterinary referral centers. Yet, there is little information currently available on the use of these modalities for the diagnosis and characterization of these vascular alterations. The purpose of this article is to review the CT and ultrasonographic findings of acquired vascular diseases in the abdomen of dogs and cats, using both the veterinary and human medicine literature as references, and highlighting essential concepts through figures.

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Primary splenic torsion in dogs: 102 cases (1992–2014)

Abstract: Results suggested that the prognosis for dogs undergoing splenectomy because of PST was favorable. Several risk factors for death prior to discharge were identified, including preexisting septic peritonitis, intraoperative hemorrhage, and postoperative development of respiratory distress.

Cited by 26 publications

References 20 publications

CT characteristics of primary splenic torsion in eight dogs

CT characteristics of primary splenic torsion in eight dogs

Molecular detection of vector-borne pathogens in blood and splenic samples from dogs with splenic disease

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

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