Hepatic lobe torsion in a Golden Retriever puppy: diagnosis and intervention

Abstract

Hepatic lobe torsion occurs when a liver lobe twists around its axis that results in the obstruction of hepatic and portal veins leading to necrosis of the liver lobe and toxemia of the patient. Single lobe affected is very common, especially torsion of the left lateral lobe accounting for nearly 50% of all cases.Liver lobe torsion is quite rare and often occurs in the middle-aged dogs but it happened in this case as young age dog, a female Golden Retriever 3 months-old puppy, namely Tully that had been sent to Animal Emergency Center for the condition of suddenly having defecation then became very lethargic and started dyspnea, pale mucous membrane, abdominal pain, vomit.Abdomen was distended with palpable fluid wave. Abdominal ultrasound and abdocentesis found fluid-filled bloody fluid. Radiograph and ultrasound are commonly used for diagnosis. It could be differentiated from mass lesions and nonsurgical diseases of the liver, such as hepatitis.Laboratory test result showed the condition of acidemia with respiratory and metabolic lactic acidosis. Higher PCV/Tp of abdominal fluid compared to peripheral blood indicated active hemorrhage within abdominal cavity. PRBC transfusion was performed. Fresh frozen plasma was administered when serum albumin levels were below 2.0g/dL. The abdominal radiography found a cranial abdominal mass, loss of abdominal detail due to peritoneal effusion.Emergency exploratory laparotomy performed. Liver lobe torsion noted. The torsed-necrosis lobe was excised. Most cases are well recovered after reconstruction surgery.