A 7- year- old, male canine was referred with apathy and anorexia from last four days. Radiography revealed splenomegaly
and ultrasound showed a “lacy parenchyma” with “hyperechoic perivenous” triangle. A tentative diagnosis of splenic
torsion was made. The CT examination was performed for special reconstructions and to obtain additional information
to confirm the diagnosis. Images in an oblique plane transversal to the splenic arteries and veins were reconstructed.
Looking at these images in a fast forward video mode, the rotated pedicle, containing the splenic vessels along the gastrosplenic
ligament, surrounded by the twisted, striated, hyperattenuating fat had a striking resemblance to a meteorological
satellite video of a tornado. The “Tornado sign” is a characteristic, possibly pathognomonic sign of splenic torsion. Splenic
torsion was than confirmed on exploratory laparotomy. The dog recovered completely with supportive care. In conclusion,
if torsion of an organ is suspected and computed tomographic images in standard planes fail to demonstrate and
identify the rotation, images perpendicular to the pedicle and/or main mesenteric or hilar vessels supplying the organ
should be reconstructed and evaluated in a fast forward video mode as an additional diagnostic tool.
Isolated Splenic Torsion is a rare condition in dogs with unspecific
clinical signs. The Great Dane and German Shepherd
dogs are found to be at increased risk for isolated splenic torsion. No age or sex predilection is known. For diagnosing
splenic torsion radiographic and ultrasound examinations
are further strongly recommended diagnostic tests, but none
is necessarily pathognomonic. Laparotomy is the gold
standard to confirm splenic torsion. With CT examination and
special reconstructions additional information is obtained to
confirm the tentative diagnosis of splenic torsion before surgery.A 7- year- old, male Hovawart was referred with apathy and
anorexia from last four days. The dog was treated with antibiotics
(Doxycyclin, Streptomycin, Metamizol) by the local veterinarian
without any improvement. Upon the presentation
at the clinic, the dog was alert, mildly dehydrated (< 5%), exhibited
increased rectal temperature of 39.5°C and heart rate
of 100 bpm. A mass was palpated in the mid-abdomen. While
the abdomen was examined, the dog was painful. The remaining
physical examination findings were within normal limits.
Complete blood examination was carried out.
Complete blood count revealed elevated leucocytes (19+109
/l),
decreased hematocrit (31%) and increased ALT (407 U/L), AP
(1122 U/l) and Bilirubin (8,8 µmol/l).
The right lateral and ventrodorsal abdominal radiographs of
the spleen revealed enlarged spleen with round margins. The
dorsal extremity of the spleen, normally situated in the left
hypogastric region, was displaced to the right side. The ventral
extremity extended to the level of the fourth lumbar vertebra
in the midventral line. No gas accumulations were seen within
the spleen.
Abdominal CT examination was performed with a 64-slice, helical
CT scanner (Somatom Definition AS, Siemens Healthcare,
Erlangen, Germany). The dog was placed in sternal recumbency
under general inhalation anesthesia. Breath hold technique
in exspiration was used to minimize motion artifacts.
Transverse images of the abdomen were acquired using 64x
0.6-mm detector collimation, 120 KVp, 120 mA, 1sec rotation
time and 512x512 reconstructed image matrix. A soft tissue
algorithm (B26f) was used for reconstruction. Further, a dualphase
post contrast study was done, using 600 mg iodine per
kg BW intravenous contrast agent (Iohexol, Accupaque 300,
GE Healthcare Buchler GmbH&Co. KG, Braunschwaig, Germany)
administered via power injector at a rate of 2.9 ml/
sec in the cephalic vein (total contrast dose 68.1 ml; 22.9 sec
contrast flow duration). A region of interest was placed in the
aorta at the level of the cardiophrenic angle, and the arterial
scan was started with a delay of 5 seconds after a peak of 100
Hounsfield Units (HU) in the descending thoracic aorta. The
late phase was started with a delay of 43 seconds after a peak
of 100 HU in the descending thoracic aorta.
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