Surgical portasystemic shunt between the portal vein and inferior vena cava.
A syndrome characterized by central nervous system dysfunction in association with LIVER FAILURE, including portal-systemic shunts. Clinical features include lethargy and CONFUSION (frequently progressing to COMA); ASTERIXIS; NYSTAGMUS, PATHOLOGIC; brisk oculovestibular reflexes; decorticate and decerebrate posturing; MUSCLE SPASTICITY; and bilateral extensor plantar reflexes (see REFLEX, BABINSKI). ELECTROENCEPHALOGRAPHY may demonstrate triphasic waves. (From Adams et al., Principles of Neurology, 6th ed, pp1117-20; Plum & Posner, Diagnosis of Stupor and Coma, 3rd ed, p222-5)
Dilated blood vessels in the ESOPHAGUS or GASTRIC FUNDUS that shunt blood from the portal circulation (PORTAL SYSTEM) to the systemic venous circulation. Often they are observed in individuals with portal hypertension (HYPERTENSION, PORTAL).
Abnormal increase of resistance to blood flow within the hepatic PORTAL SYSTEM, frequently seen in LIVER CIRRHOSIS and conditions with obstruction of the PORTAL VEIN.
Surgical venous shunt between the portal and systemic circulation to effect decompression of the portal circulation. It is performed primarily in the treatment of bleeding esophageal varices resulting from portal hypertension. Types of shunt include portacaval, splenorenal, mesocaval, splenocaval, left gastric-caval (coronary-caval), portarenal, umbilicorenal, and umbilicocaval.
Bleeding in any segment of the GASTROINTESTINAL TRACT from ESOPHAGUS to RECTUM.
A short thick vein formed by union of the superior mesenteric vein and the splenic vein.
A system of vessels in which blood, after passing through one capillary bed, is conveyed through a second set of capillaries before it returns to the systemic circulation. It pertains especially to the hepatic portal system.
Accumulation or retention of free fluid within the peritoneal cavity.
A type of surgical portasystemic shunt to reduce portal hypertension with associated complications of esophageal varices and ascites. It is performed percutaneously through the jugular vein and involves the creation of an intrahepatic shunt between the hepatic vein and portal vein. The channel is maintained by a metallic stent. The procedure can be performed in patients who have failed sclerotherapy and is an additional option to the surgical techniques of portocaval, mesocaval, and splenorenal shunts. It takes one to three hours to perform. (JAMA 1995;273(23):1824-30)
Treatment of varicose veins, hemorrhoids, gastric and esophageal varices, and peptic ulcer hemorrhage by injection or infusion of chemical agents which cause localized thrombosis and eventual fibrosis and obliteration of the vessels.
The circulation of BLOOD through the LIVER.
FIBROSIS of the hepatic parenchyma due to chronic excess ALCOHOL DRINKING.
Liver disease in which the normal microcirculation, the gross vascular anatomy, and the hepatic architecture have been variably destroyed and altered with fibrous septa surrounding regenerated or regenerating parenchymal nodules.
Surgical creation of a communication between a cerebral ventricle and the peritoneum by means of a plastic tube to permit drainage of cerebrospinal fluid for relief of hydrocephalus. (From Dorland, 28th ed)
Situations or conditions requiring immediate intervention to avoid serious adverse results.
Blood tests that are used to evaluate how well a patient's liver is working and also to help diagnose liver conditions.
Tubes inserted to create communication between a cerebral ventricle and the internal jugular vein. Their emplacement permits draining of cerebrospinal fluid for relief of hydrocephalus or other condition leading to fluid accumulation in the ventricles.
Derived proteins or mixtures of cleavage products produced by the partial hydrolysis of a native protein either by an acid or by an enzyme. Peptones are readily soluble in water, and are not precipitable by heat, by alkalis, or by saturation with ammonium sulfate. (Dorland, 28th ed)
The blood pressure in the VEINS. It is usually measured to assess the filling PRESSURE to the HEART VENTRICLE.
A condition in which the hepatic venous outflow is obstructed anywhere from the small HEPATIC VEINS to the junction of the INFERIOR VENA CAVA and the RIGHT ATRIUM. Usually the blockage is extrahepatic and caused by blood clots (THROMBUS) or fibrous webs. Parenchymal FIBROSIS is uncommon.
Pathological processes of the LIVER.
Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body.
Vein formed by the union (at the hilus of the spleen) of several small veins from the stomach, pancreas, spleen and mesentery.
A large lobed glandular organ in the abdomen of vertebrates that is responsible for detoxification, metabolism, synthesis and storage of various substances.
The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)
An operation for the continuous emptying of ascitic fluid into the venous system. Fluid removal is based on intraperitoneal and intrathoracic superior vena cava pressure differentials and is performed via a pressure-sensitive one-way valve connected to a tube traversing the subcutaneous tissue of the chest wall to the neck where it enters the internal jugular vein and terminates in the superior vena cava. It is used in the treatment of intractable ascites.
Absolute, comparative, or differential costs pertaining to services, institutions, resources, etc., or the analysis and study of these costs.
The expenses incurred by a hospital in providing care. The hospital costs attributed to a particular patient care episode include the direct costs plus an appropriate proportion of the overhead for administration, personnel, building maintenance, equipment, etc. Hospital costs are one of the factors which determine HOSPITAL CHARGES (the price the hospital sets for its services).

Effect of portal-systemic anastomosis on renal haemodynamics in cirrhosis. (1/179)

In 12 patients with portal hypertension and repeated bleedings from oesophageal varices the central haemodynamics, portal pressure, and mean renal blood flow (RBF) were investigated immediately before and two to seven months after portal-systemic shunt. Cardiac output increased significantly, whereas arterial pressure was unchanged after operation. RBF, which was initially less than in controls, did not change. As portal pressure decreased significantly, a direct portal-renal, neural, or humoral reflex mechanism does not explain the subnormal RBF in cirrhosis. As plasma volume was large and unchanged after operation a "diminished circulating plasma volume" is an unlikely explanation. Therefore, on the basis of the present observations, previously postulated causes of renal hypoperfusion in cirrhosis need revision.  (+info)

The need to handicap the recipient's native liver in the rat model of heterotopic auxiliary liver transplantation. (2/179)

In the rat model of heterotopic auxiliary liver transplantation (HALTx), the opinion varies on whether and how the recipient's native liver should be handicapped. To avoid atrophy of the transplanted organ, in this study, two different handicaps were evaluated and their effects on post-operative animal survival and liver biology are described. With a sole portacaval shunt (group 1) all rats survived longer than 3 months. An additional handicap of the liver with either a 68% partial hepatectomy (68% PH) (group 2), or both a 68% PH and a common bile duct ligation (CBDL) (group 3) led to a 100% mortality within 2 days after surgery. When an auxiliary liver was transplanted to the rats handicapped with a 68% PH (group 4), serum Bilirubin and ALAT values were significantly lower than those handicapped with both a 68% PH and a CBDL (group 5). Autopsy and histology of the long-term survivors revealed the atrophy of the engrafted livers and the regeneration of the native livers in group 4, whereas it showed the opposite in group 5. Thus the various manipulations of the native liver do influence differently the post-transplant animal survival, serum liver biochemistry and the outcome of the engrafted liver in this rat model of HALTx.  (+info)

Emergency and elective surgical treatment of portal hypertension. A review of 23 years' experience. (3/179)

A retrospective review of surgical treatment for portal hypertension during a 23-year period in a regional unit is reported and the immediate and subsequent management of patients with bleeding oesophageal varices is discussed. Fifty-four patients with recurrent varix haemorrhage uncontrolled by conservative methods have been treated by oesophageal transection with a mortality of 22.2% (26.6% for cirrhotic patients). Thirty-two per cent of the cirrhotics were alive after 2 years. Only a minority (12%) of the survivors were considered suitable for a subsequent shunt procedure. Therapeutic portacaval anastomosis has been performed on 65 patients with a 51.2% 5-year survival (43-5% for cirrhotic patients). Further haemorrhage due to shunt thrombosis occurred in 5-3% of cases. The frequent occurrence of portal-systemic encephalopathy, increasing with duration of time following a shunt, is emphasized. The high morbidity and mortality in the poor-risk cirrhotic indicated that this type of patient is unsuitable for a portal-systemic shunt and is better treated by medical means.  (+info)

Portosystemic shunting in patients with primary biliary cirrhosis: a good risk disease. (4/179)

Five patients with primary biliary cirrhosis underwent portosystemic shunting for the control of variceal bleeding. Three procedures were emergencies and two were elective. There was no operative mortality; all patients were followed until the present or until death. One patient is alive 4 years and another, 2 years postoperatively. One patient died 4 years after operation and another died 16 months postoperatively. Another patient survived for 8 years following her shunt and eventually died as a result of a cerebrovascular accident. This group of patients is compared to a larger group undergoing portosystemic shunting because of portal hypertension secondary to other forms of liver disease. The absence of operative mortality and the fact that several of these patients had moderately long postoperative survival despite apparently poor liver function suggest that the usual criteria for the assessment of operative risk are not valid in primary biliary cirrhosis.  (+info)

Aspects of treatment. The anatomical basis for portal decompressive surgery. (5/179)

Definitive surgical techniques used in the treatment of portal hypertension all aim to achieve portal venous decompression. The historic development of the various procedures currently employed provides a broad repertoire of surgical operations. Each of the procedures merits consideration and may be specifically indicated in a given situation. Description of the operative steps emphasizes the importance of the anatomical relationships of the various structures.  (+info)

Small-diameter portacaval H-graft shunt: a paradigm shift back to surgical shunting in the management of variceal bleeding in patients with preserved liver function. (6/179)

Small-diameter portacaval H-graft (SDPHG) shunts are partial portosystemic shunts that control variceal bleeding while preserving nutrient blood flow to the liver, minimizing postoperative encephalopathy and liver failure. Since July 1, 1997, we placed SDPHG shunts in 18 patients (age, 52.1 +/- 2.6 years; range, 35 to 72 years) with cirrhosis (Child's class A, B, and C in 6, 10, and 2 patients, respectively) and refractory variceal bleeding who were not candidates for transplantation. Ten procedures (55.6%) were urgent or emergent. SDPHG shunts effectively reduced the portacaval pressure gradient (18 +/- 3 v 5 +/- 2 mm Hg; P <.05). Surgical times (210 +/- 11 minutes), estimated blood losses (358.3 +/- 107.8 mL), transfusion requirements (0 transfusions in 10 patients; 55.6%; mean, 0.9 +/- 0.3 units), and postoperative hospitalization (7.7 +/- 1.0 days) were excellent. Surgical mortality (30 days) was 0%. During 14. 0 +/- 1.9 months (range, 1.1 to 29.1 months) of follow-up, 4 patients (22.2%) died, including both patients with Child's class C cirrhosis. The cumulative 1-year survival rate was 82.1% (Child's class A, B, and C, 83.3%, 90%, and 0%, respectively). Long-term survivors had significantly lower preoperative Child-Pugh scores compared with nonsurvivors (7.8 +/- 0.3 v 9.5 +/- 1.0; P <.05). Postoperative encephalopathy developed in 3 survivors (20%). Fifteen patients (83.3%) have not experienced rebleeding; shunt failure led to rebleeding in only 1 patient (5.6%). SDPHG shunt placement can be performed with low morbidity and surgical mortality. Nontransplantation candidates with Child's class A and B cirrhosis have excellent long-term survival with this safe, effective, and definitive treatment for refractory variceal bleeding.  (+info)

Spontaneous reversal of portal blood flow: the case for and against its occurrence in patients with cirrhosis of the liver. (7/179)

Because of its presumed serious clinical significance, we made an analysis of the evidence for and against the occurrence of spontaneous reversal of portal flow in cirrhosis of the liver. We examined the evidence obtained from manometric studies, radioactive tracer studies, radiologic studies, and actual measurements of magnitude and direction of portal blood flow. Concerning manometric studies, we introduced a physical analysis, based on first principles, which demonstrates that the occluded portal pressures cannot be used to construct a hydraulic gradient for portal flow. Similarly, we examined the weakness of the evidence derived from radioactive tracer and radiologic studies and, in the latter, the drastically opposite results reported by different investigators. Finally, we found that actual measurements of magnitude and direction of portal flow provide impressive evidence against the occurrence of spontaneous reversal of portal flow in cirrhosis. We conclude that unless new and convincing evidence is provided, it may not serve the best interests of medicine and of our patients to continue accepting spontaneous reversal of portal flow in cirrhosis as if it were a proven phenomenon.  (+info)

The hepatorenal syndrome: recovery after portacaval shunt. (8/179)

Reversal of the morbid hepato-renal syndrome has been achieved in a cirrhotic patient with ascites following successful side-to-side portacaval shunt. The hepatorenal syndrome is defined as progressive unresponsive renal failure with previously normal kidneys in the presence of impaired hepatic function. Although the etiologic mechanism has not been defined, it is suggested the relationship of increased intrahepatic sinusoidal pressure on the thoracic duct and subsequent decreased lymph flow are interrelated to increased levels of aldosterone and manifested by (chylous) ascites. Laboratory and clinical evidence suggest that cirrhotics with ascites have remarkably high levels of aldosterone secretion via the rennin-angiotensin-adrenal cortex mechanism. This is the group that develops hepatorenal syndrome. Reduction of the intrahepatic pressure and decompression of the portal hypertension can be successfully achieved with a side-to-side shunt which should return the aldosterone-rennin-angiotensin axis to normal and subsequently reverse the hepatorenal syndrome.  (+info)

A portacaval shunt is a surgical procedure that creates an alternate pathway for blood flow between the portal vein and the inferior vena cava. The portal vein carries blood from the gastrointestinal tract, liver, spleen, and pancreas to the liver. In certain medical conditions, such as severe liver disease or portal hypertension, the blood pressure in the portal vein becomes abnormally high, which can lead to serious complications like variceal bleeding.

In a surgical portacaval shunt procedure, a surgeon creates a connection between the portal vein and the inferior vena cava, allowing a portion of the blood from the portal vein to bypass the liver and flow directly into the systemic circulation. This helps reduce the pressure in the portal vein and prevent complications associated with portal hypertension.

There are different types of portacaval shunts, including:

1. Direct portacaval shunt: In this procedure, the surgeon directly connects the portal vein to the inferior vena cava.
2. Side-to-side portacaval shunt: Here, the surgeon creates an anastomosis (connection) between a side branch of the portal vein and the inferior vena cava.
3. H-type shunt: This involves creating two separate connections between the portal vein and the inferior vena cava, forming an "H" shape.

It is important to note that while portacaval shunts can be effective in managing complications of portal hypertension, they may also have potential risks and side effects, such as worsening liver function, encephalopathy, or heart failure. Therefore, the decision to perform a portacaval shunt should be made carefully, considering the individual patient's medical condition and overall health.

Hepatic encephalopathy (HE) is a neuropsychiatric syndrome associated with liver dysfunction and/or portosystemic shunting. It results from the accumulation of toxic substances, such as ammonia and inflammatory mediators, which are normally metabolized by the liver. HE can present with a wide range of symptoms, including changes in sleep-wake cycle, altered mental status, confusion, disorientation, asterixis (flapping tremor), and in severe cases, coma. The diagnosis is based on clinical evaluation, neuropsychological testing, and exclusion of other causes of cognitive impairment. Treatment typically involves addressing the underlying liver dysfunction, reducing ammonia production through dietary modifications and medications, and preventing further episodes with lactulose or rifaximin therapy.

Esophageal varices and gastric varices are abnormal, enlarged veins in the lower part of the esophagus (the tube that connects the throat to the stomach) and in the stomach lining, respectively. They occur as a result of increased pressure in the portal vein, which is the large blood vessel that carries blood from the digestive organs to the liver. This condition is known as portal hypertension.

Esophageal varices are more common than gastric varices and tend to be more symptomatic. They can cause bleeding, which can be life-threatening if not treated promptly. Gastric varices may also bleed, but they are often asymptomatic until they rupture.

The most common causes of esophageal and gastric varices are cirrhosis (scarring of the liver) and portal hypertension due to other liver diseases such as schistosomiasis or Budd-Chiari syndrome. Treatment options for esophageal and gastric varices include medications to reduce bleeding, endoscopic therapies to treat active bleeding or prevent recurrent bleeding, and surgical procedures to relieve portal hypertension.

Portal hypertension is a medical condition characterized by an increased pressure in the portal vein, which is the large blood vessel that carries blood from the intestines, spleen, and pancreas to the liver. Normal portal venous pressure is approximately 5-10 mmHg. Portal hypertension is defined as a portal venous pressure greater than 10 mmHg.

The most common cause of portal hypertension is cirrhosis of the liver, which leads to scarring and narrowing of the small blood vessels in the liver, resulting in increased resistance to blood flow. Other causes include blood clots in the portal vein, inflammation of the liver or bile ducts, and invasive tumors that block the flow of blood through the liver.

Portal hypertension can lead to a number of complications, including the development of abnormal blood vessels (varices) in the esophagus, stomach, and intestines, which are prone to bleeding. Ascites, or the accumulation of fluid in the abdominal cavity, is another common complication of portal hypertension. Other potential complications include encephalopathy, which is a condition characterized by confusion, disorientation, and other neurological symptoms, and an increased risk of bacterial infections.

Treatment of portal hypertension depends on the underlying cause and the severity of the condition. Medications to reduce pressure in the portal vein, such as beta blockers or nitrates, may be used. Endoscopic procedures to band or inject varices can help prevent bleeding. In severe cases, surgery or liver transplantation may be necessary.

A portosystemic shunt is a surgical procedure that creates a connection between the portal vein (the blood vessel that carries blood from the digestive organs to the liver) and another systemic vein (a vein that carries blood away from the liver). This procedure is typically performed in animals, particularly dogs, to treat conditions such as portal hypertension or liver disease.

In a surgical portosystemic shunt, the surgeon creates a connection between the portal vein and a systemic vein, allowing blood from the digestive organs to bypass the liver. This can help to reduce the pressure in the portal vein and improve blood flow to the liver. The specific type of shunt created and the surgical approach used may vary depending on the individual patient's needs and the surgeon's preference.

It is important to note that while a surgical portosystemic shunt can be an effective treatment for certain conditions, it is not without risks and potential complications. As with any surgical procedure, there is always a risk of infection, bleeding, or other complications. Additionally, the creation of a portosystemic shunt can have long-term effects on the liver and overall health of the patient. It is important for pet owners to carefully consider the risks and benefits of this procedure and to discuss any questions or concerns they may have with their veterinarian.

Gastrointestinal (GI) hemorrhage is a term used to describe any bleeding that occurs in the gastrointestinal tract, which includes the esophagus, stomach, small intestine, large intestine, and rectum. The bleeding can range from mild to severe and can produce symptoms such as vomiting blood, passing black or tarry stools, or having low blood pressure.

GI hemorrhage can be classified as either upper or lower, depending on the location of the bleed. Upper GI hemorrhage refers to bleeding that occurs above the ligament of Treitz, which is a point in the small intestine where it becomes narrower and turns a corner. Common causes of upper GI hemorrhage include gastritis, ulcers, esophageal varices, and Mallory-Weiss tears.

Lower GI hemorrhage refers to bleeding that occurs below the ligament of Treitz. Common causes of lower GI hemorrhage include diverticulosis, colitis, inflammatory bowel disease, and vascular abnormalities such as angiodysplasia.

The diagnosis of GI hemorrhage is often made based on the patient's symptoms, medical history, physical examination, and diagnostic tests such as endoscopy, CT scan, or radionuclide scanning. Treatment depends on the severity and cause of the bleeding and may include medications, endoscopic procedures, surgery, or a combination of these approaches.

The portal vein is the large venous trunk that carries blood from the gastrointestinal tract, spleen, pancreas, and gallbladder to the liver. It is formed by the union of the superior mesenteric vein (draining the small intestine and a portion of the large intestine) and the splenic vein (draining the spleen and pancreas). The portal vein then divides into right and left branches within the liver, where the blood flows through the sinusoids and gets enriched with oxygen and nutrients before being drained by the hepatic veins into the inferior vena cava. This unique arrangement allows the liver to process and detoxify the absorbed nutrients, remove waste products, and regulate metabolic homeostasis.

A portal system in medicine refers to a venous system in which veins from various tissues or organs (known as tributaries) drain into a common large vessel (known as the portal vein), which then carries the blood to a specific organ for filtration and processing before it is returned to the systemic circulation. The most well-known example of a portal system is the hepatic portal system, where veins from the gastrointestinal tract, spleen, pancreas, and stomach merge into the portal vein and then transport blood to the liver for detoxification and nutrient processing. Other examples include the hypophyseal portal system, which connects the hypothalamus to the anterior pituitary gland, and the renal portal system found in some animals.

Ascites is an abnormal accumulation of fluid in the peritoneal cavity, which is the space between the lining of the abdominal wall and the organs within it. This buildup of fluid can cause the belly to swell and become distended. Ascites can be caused by various medical conditions, including liver cirrhosis, cancer, heart failure, and kidney disease. The accumulation of fluid in the peritoneal cavity can lead to complications such as infection, reduced mobility, and difficulty breathing. Treatment for ascites depends on the underlying cause and may include diuretics, paracentesis (a procedure to remove excess fluid from the abdomen), or treatment of the underlying medical condition.

A Transjugular Intrahepatic Portosystemic Shunt (TIPS) is a medical procedure that creates an alternative pathway for blood flow from the portal vein to the hepatic vein within the liver. This shunt is composed of a stent, which is a small metal tube that is inserted into the liver using a long needle that is passed through a vein in the neck (jugular vein).

TIPS is typically used to treat complications of portal hypertension, such as variceal bleeding, ascites, and hepatic hydrothorax. By creating a shunt that bypasses the liver, TIPS reduces the pressure in the portal vein, which can help to alleviate these symptoms. However, because the shunt allows blood to bypass the liver, it can also impair liver function and lead to other complications, such as hepatic encephalopathy.

It is important to note that TIPS is a complex procedure that should only be performed by experienced interventional radiologists in a hospital setting with appropriate medical backup and monitoring capabilities.

Sclerotherapy is a medical procedure used to treat varicose veins and spider veins. It involves the injection of a solution (called a sclerosant) directly into the affected vein, which causes the vein to collapse and eventually fade away. The sclerosant works by irritating the lining of the vein, causing it to swell and stick together, which then leads to clotting and the eventual reabsorption of the vein by the body.

The procedure is typically performed in a doctor's office or outpatient setting and may require multiple sessions depending on the severity and number of veins being treated. Common side effects include bruising, swelling, and discomfort at the injection site, as well as the possibility of developing brownish pigmentation or small ulcers near the treatment area. However, these side effects are usually temporary and resolve on their own within a few weeks.

Sclerotherapy is considered a safe and effective treatment for varicose veins and spider veins, with high success rates and low complication rates. It is important to note that while sclerotherapy can improve the appearance of affected veins, it does not prevent new veins from developing in the future.

Liver circulation, also known as hepatic circulation, refers to the blood flow through the liver. The liver receives blood from two sources: the hepatic artery and the portal vein.

The hepatic artery delivers oxygenated blood from the heart to the liver, accounting for about 25% of the liver's blood supply. The remaining 75% comes from the portal vein, which carries nutrient-rich, deoxygenated blood from the gastrointestinal tract, spleen, pancreas, and gallbladder to the liver.

In the liver, these two sources of blood mix in the sinusoids, small vessels with large spaces between the endothelial cells that line them. This allows for efficient exchange of substances between the blood and the hepatocytes (liver cells). The blood then leaves the liver through the hepatic veins, which merge into the inferior vena cava and return the blood to the heart.

The unique dual blood supply and extensive sinusoidal network in the liver enable it to perform various critical functions, such as detoxification, metabolism, synthesis, storage, and secretion of numerous substances, maintaining body homeostasis.

Alcoholic Liver Cirrhosis is a medical condition characterized by irreversible scarring (fibrosis) and damage to the liver caused by excessive consumption of alcohol over an extended period. The liver's normal structure and function are progressively impaired as healthy liver tissue is replaced by scarred tissue, leading to the formation of nodules (regenerative noduli).

The condition typically develops after years of heavy drinking, with a higher risk for those who consume more than 60 grams of pure alcohol daily. The damage caused by alcoholic liver cirrhosis can be life-threatening and may result in complications such as:

1. Ascites (accumulation of fluid in the abdomen)
2. Encephalopathy (neurological dysfunction due to liver failure)
3. Esophageal varices (dilated veins in the esophagus that can rupture and bleed)
4. Hepatorenal syndrome (kidney failure caused by liver disease)
5. Increased susceptibility to infections
6. Liver cancer (hepatocellular carcinoma)
7. Portal hypertension (increased blood pressure in the portal vein that supplies blood to the liver)

Abstaining from alcohol and managing underlying medical conditions are crucial for slowing down or halting disease progression. Treatment may involve medications, dietary changes, and supportive care to address complications. In severe cases, a liver transplant might be necessary.

Liver cirrhosis is a chronic, progressive disease characterized by the replacement of normal liver tissue with scarred (fibrotic) tissue, leading to loss of function. The scarring is caused by long-term damage from various sources such as hepatitis, alcohol abuse, nonalcoholic fatty liver disease, and other causes. As the disease advances, it can lead to complications like portal hypertension, fluid accumulation in the abdomen (ascites), impaired brain function (hepatic encephalopathy), and increased risk of liver cancer. It is generally irreversible, but early detection and treatment of underlying causes may help slow down its progression.

A Ventriculoperitoneal (VP) shunt is a surgical procedure that involves the insertion of a long, flexible tube (shunt) into the cerebral ventricles of the brain to drain excess cerebrospinal fluid (CSF). The other end of the shunt is directed into the peritoneal cavity, where the CSF can be absorbed.

The VP shunt is typically used to treat hydrocephalus, a condition characterized by an abnormal accumulation of CSF within the ventricles of the brain, which can cause increased intracranial pressure and damage to the brain. By diverting the excess CSF from the ventricles into the peritoneal cavity, the VP shunt helps to relieve the symptoms of hydrocephalus and prevent further neurological damage.

The shunt system consists of several components, including a ventricular catheter that is placed in the ventricle, a one-way valve that regulates the flow of CSF, and a distal catheter that is directed into the peritoneal cavity. The valve helps to prevent backflow of CSF into the brain and ensures that the fluid flows in only one direction, from the ventricles to the peritoneal cavity.

VP shunts are generally safe and effective, but they can be associated with complications such as infection, obstruction, or malfunction of the shunt system. Regular follow-up with a healthcare provider is necessary to monitor the function of the shunt and ensure that any potential issues are addressed promptly.

An emergency is a sudden, unexpected situation that requires immediate medical attention to prevent serious harm, permanent disability, or death. Emergencies can include severe injuries, trauma, cardiac arrest, stroke, difficulty breathing, severe allergic reactions, and other life-threatening conditions. In such situations, prompt medical intervention is necessary to stabilize the patient's condition, diagnose the underlying problem, and provide appropriate treatment.

Emergency medical services (EMS) are responsible for providing emergency care to patients outside of a hospital setting, such as in the home, workplace, or public place. EMS personnel include emergency medical technicians (EMTs), paramedics, and other first responders who are trained to assess a patient's condition, provide basic life support, and transport the patient to a hospital for further treatment.

In a hospital setting, an emergency department (ED) is a specialized unit that provides immediate care to patients with acute illnesses or injuries. ED staff includes physicians, nurses, and other healthcare professionals who are trained to handle a wide range of medical emergencies. The ED is equipped with advanced medical technology and resources to provide prompt diagnosis and treatment for critically ill or injured patients.

Overall, the goal of emergency medical care is to stabilize the patient's condition, prevent further harm, and provide timely and effective treatment to improve outcomes and save lives.

Liver function tests (LFTs) are a group of blood tests that are used to assess the functioning and health of the liver. These tests measure the levels of various enzymes, proteins, and waste products that are produced or metabolized by the liver. Some common LFTs include:

1. Alanine aminotransferase (ALT): An enzyme found primarily in the liver, ALT is released into the bloodstream in response to liver cell damage. Elevated levels of ALT may indicate liver injury or disease.
2. Aspartate aminotransferase (AST): Another enzyme found in various tissues, including the liver, heart, and muscles. Like ALT, AST is released into the bloodstream following tissue damage. High AST levels can be a sign of liver damage or other medical conditions.
3. Alkaline phosphatase (ALP): An enzyme found in several organs, including the liver, bile ducts, and bones. Elevated ALP levels may indicate a blockage in the bile ducts, liver disease, or bone disorders.
4. Gamma-glutamyl transferase (GGT): An enzyme found mainly in the liver, pancreas, and biliary system. Increased GGT levels can suggest liver disease, alcohol consumption, or the use of certain medications.
5. Bilirubin: A yellowish pigment produced when hemoglobin from red blood cells is broken down. Bilirubin is processed by the liver and excreted through bile. High bilirubin levels can indicate liver dysfunction, bile duct obstruction, or certain types of anemia.
6. Albumin: A protein produced by the liver that helps maintain fluid balance in the body and transports various substances in the blood. Low albumin levels may suggest liver damage, malnutrition, or kidney disease.
7. Total protein: A measure of all proteins present in the blood, including albumin and other types of proteins produced by the liver. Decreased total protein levels can indicate liver dysfunction or other medical conditions.

These tests are often ordered together as part of a routine health checkup or when evaluating symptoms related to liver function or disease. The results should be interpreted in conjunction with clinical findings, medical history, and other diagnostic tests.

Cerebrospinal fluid (CSF) shunts are medical devices used to divert the flow of excess CSF from the brain and spinal cord to another part of the body, usually the abdominal cavity. The shunt consists of a catheter, a valve, and a reservoir.

The catheter is inserted into one of the ventricles in the brain or the subarachnoid space surrounding the spinal cord to drain the excess CSF. The valve regulates the flow of CSF to prevent over-drainage, which can cause complications such as low CSF pressure and brain sagging. The reservoir is a small chamber that allows for easy access to the shunt system for monitoring and adjusting the pressure settings.

CSF shunts are typically used to treat conditions associated with increased production or impaired absorption of CSF, such as hydrocephalus, communicating hydrocephalus, normal pressure hydrocephalus, and pseudotumor cerebri. By reducing the buildup of CSF in the brain, shunts can help alleviate symptoms such as headaches, nausea, vomiting, vision problems, and cognitive impairment.

It is important to note that while CSF shunts are effective in managing these conditions, they also carry risks of complications such as infection, obstruction, malfunction, and over-drainage. Regular monitoring and follow-up care are necessary to ensure proper functioning and minimize the risk of complications.

Peptones are not a medical term per se, but they are commonly used in medical and clinical laboratory settings. Peptones are complex organic compounds that result from the partial hydrolysis of proteins. They consist of a mixture of polypeptides, peptides, and free amino acids.

In medical laboratories, peptones are often used as a nutrient source in various culture media for the growth of microorganisms such as bacteria and fungi. Peptone water is a common liquid medium used to culture and isolate bacteria. It contains peptones, sodium chloride, and other ingredients that provide essential nutrients for bacterial growth.

Peptones are also used in biochemical tests to identify specific microorganisms based on their ability to metabolize certain components of the peptone. For example, in the sulfur-indole-motility (SIM) medium, peptones serve as a source of amino acids and other nutrients that support the growth of bacteria producing enzymes responsible for the production of indole from tryptophan.

Venous pressure is the pressure exerted on the walls of a vein, which varies depending on several factors such as the volume and flow of blood within the vein, the contractile state of the surrounding muscles, and the position of the body. In clinical settings, venous pressure is often measured in the extremities (e.g., arms or legs) to assess the functioning of the cardiovascular system.

Central venous pressure (CVP) is a specific type of venous pressure that refers to the pressure within the large veins that enter the right atrium of the heart. CVP is an important indicator of right heart function and fluid status, as it reflects the amount of blood returning to the heart and the ability of the heart to pump it forward. Normal CVP ranges from 0 to 8 mmHg (millimeters of mercury) in adults.

Elevated venous pressure can be caused by various conditions such as heart failure, obstruction of blood flow, or fluid overload, while low venous pressure may indicate dehydration or blood loss. Accurate measurement and interpretation of venous pressure require specialized equipment and knowledge, and are typically performed by healthcare professionals in a clinical setting.

Budd-Chiari syndrome is a rare condition characterized by the obstruction of the hepatic veins, which are the blood vessels that carry blood from the liver to the heart. This obstruction can be caused by blood clots, tumors, or other abnormalities, and it can lead to a backflow of blood in the liver, resulting in various symptoms such as abdominal pain, swelling, and liver enlargement. In severe cases, Budd-Chiari syndrome can cause liver failure and other complications if left untreated. The diagnosis of this condition typically involves imaging tests such as ultrasound, CT scan, or MRI, and treatment may include anticoagulation therapy, thrombolytic therapy, or surgical intervention to remove the obstruction.

Liver diseases refer to a wide range of conditions that affect the normal functioning of the liver. The liver is a vital organ responsible for various critical functions such as detoxification, protein synthesis, and production of biochemicals necessary for digestion.

Liver diseases can be categorized into acute and chronic forms. Acute liver disease comes on rapidly and can be caused by factors like viral infections (hepatitis A, B, C, D, E), drug-induced liver injury, or exposure to toxic substances. Chronic liver disease develops slowly over time, often due to long-term exposure to harmful agents or inherent disorders of the liver.

Common examples of liver diseases include hepatitis, cirrhosis (scarring of the liver tissue), fatty liver disease, alcoholic liver disease, autoimmune liver diseases, genetic/hereditary liver disorders (like Wilson's disease and hemochromatosis), and liver cancers. Symptoms may vary widely depending on the type and stage of the disease but could include jaundice, abdominal pain, fatigue, loss of appetite, nausea, and weight loss.

Early diagnosis and treatment are essential to prevent progression and potential complications associated with liver diseases.

Endoscopy is a medical procedure that involves the use of an endoscope, which is a flexible tube with a light and camera at the end, to examine the interior of a body cavity or organ. The endoscope is inserted through a natural opening in the body, such as the mouth or anus, or through a small incision. The images captured by the camera are transmitted to a monitor, allowing the physician to visualize the internal structures and detect any abnormalities, such as inflammation, ulcers, or tumors. Endoscopy can also be used for diagnostic purposes, such as taking tissue samples for biopsy, or for therapeutic purposes, such as removing polyps or performing minimally invasive surgeries.

The splenic vein is a large, thin-walled vein that carries oxygenated blood from the spleen and pancreas to the liver. It is formed by the union of several smaller veins that drain the upper part of the stomach, the pancreas, and the left side of the colon (splenic flexure). The splenic vein runs along the top border of the pancreas and merges with the superior mesenteric vein to form the portal vein. This venous system allows for the filtration and detoxification of blood by the liver before it is distributed to the rest of the body.

The liver is a large, solid organ located in the upper right portion of the abdomen, beneath the diaphragm and above the stomach. It plays a vital role in several bodily functions, including:

1. Metabolism: The liver helps to metabolize carbohydrates, fats, and proteins from the food we eat into energy and nutrients that our bodies can use.
2. Detoxification: The liver detoxifies harmful substances in the body by breaking them down into less toxic forms or excreting them through bile.
3. Synthesis: The liver synthesizes important proteins, such as albumin and clotting factors, that are necessary for proper bodily function.
4. Storage: The liver stores glucose, vitamins, and minerals that can be released when the body needs them.
5. Bile production: The liver produces bile, a digestive juice that helps to break down fats in the small intestine.
6. Immune function: The liver plays a role in the immune system by filtering out bacteria and other harmful substances from the blood.

Overall, the liver is an essential organ that plays a critical role in maintaining overall health and well-being.

I believe there might be a misunderstanding in your question. "Dogs" is not a medical term or condition. It is the common name for a domesticated carnivore of the family Canidae, specifically the genus Canis, which includes wolves, foxes, and other extant and extinct species of mammals. Dogs are often kept as pets and companions, and they have been bred in a wide variety of forms and sizes for different purposes, such as hunting, herding, guarding, assisting police and military forces, and providing companionship and emotional support.

If you meant to ask about a specific medical condition or term related to dogs, please provide more context so I can give you an accurate answer.

A Peritoneovenous Shunt is a medical device used to treat severe ascites, a condition characterized by the accumulation of excess fluid in the abdominal cavity. The shunt consists of a small tube or catheter that is surgically implanted into the abdominal cavity and connected to another tube that is inserted into a vein, usually in the chest or neck.

The shunt works by allowing the excess fluid in the abdomen to flow through the tube and into the bloodstream, where it can be eliminated from the body through the kidneys. This helps to alleviate the symptoms of ascites, such as abdominal pain and swelling, and can improve the patient's quality of life.

Peritoneovenous shunts are typically used in patients who have not responded to other treatments for ascites, such as diuretics or paracentesis (a procedure in which excess fluid is drained from the abdomen using a needle and syringe). While peritoneovenous shunts can be effective in managing ascites, they do carry some risks, including infection, bleeding, and blockage of the shunt. As with any surgical procedure, it's important for patients to discuss the potential benefits and risks with their healthcare provider before deciding whether a peritoneovenous shunt is right for them.

Costs refer to the total amount of resources, such as money, time, and labor, that are expended in the provision of a medical service or treatment. Costs can be categorized into direct costs, which include expenses directly related to patient care, such as medication, supplies, and personnel; and indirect costs, which include overhead expenses, such as rent, utilities, and administrative salaries.

Cost analysis is the process of estimating and evaluating the total cost of a medical service or treatment. This involves identifying and quantifying all direct and indirect costs associated with the provision of care, and analyzing how these costs may vary based on factors such as patient volume, resource utilization, and reimbursement rates.

Cost analysis is an important tool for healthcare organizations to understand the financial implications of their operations and make informed decisions about resource allocation, pricing strategies, and quality improvement initiatives. It can also help policymakers and payers evaluate the cost-effectiveness of different treatment options and develop evidence-based guidelines for clinical practice.

Hospital costs are the total amount of money that is expended by a hospital to provide medical and healthcare services to patients. These costs can include expenses related to:

* Hospital staff salaries and benefits
* Supplies, such as medications, medical devices, and surgical equipment
* Utilities, such as electricity, water, and heating
* Facility maintenance and renovation
* Equipment maintenance and purchase
* Administrative costs, such as billing and insurance processing

Hospital costs can also be classified into fixed and variable costs. Fixed costs are those that do not change with the volume of services provided, such as rent or depreciation of equipment. Variable costs are those that change with the volume of services provided, such as supplies and medications.

It's important to note that hospital costs can vary widely depending on factors such as the complexity of care provided, the geographic location of the hospital, and the patient population served. Additionally, hospital costs may not always align with charges or payments for healthcare services, which can be influenced by factors such as negotiated rates with insurance companies and government reimbursement policies.

When is a portacaval shunt indicated in the treatment of cirrhosis?. What is the role of transjugular intrahepatic ... Surgical Risks. Surgery and general anesthesia carry increased risks in the patient with cirrhosis. Anesthesia reduces cardiac ... Peritoneovenous shunts. LeVeen shunts and Denver shunts are devices that permit the return of ascites fluid and proteins to the ... Portosystemic shunts and transjugular intrahepatic portosystemic shunts. The prime indication for portocaval shunt surgery is ...
... and wedge hepatic venography with manometry is indicated before surgical portacaval shunt placement. ... side-to-side portocaval shunts, surgical or spontaneous splenorenal shunts with cirrhosis, and tricuspid regurgitation ( ... and splenorenal shunts (Warren shunt). Mesocaval and splenorenal shunts are used more frequently to maintain portal venous ... Because of its proven safety and effectiveness, TIPS has largely replaced surgical decompressive shunt procedures. [21, 22, 23 ...
Some forms of Budd-Chiari may be treated with surgical shunts (such as portacaval shunt) to divert blood flow around the ... TIPS accomplishes the same goal as a surgical shunt but has a lower procedure-related mortality, a factor that has led to a ... Shunts must be placed early after diagnosis for best results. TIPS (transjugular intrahepatic portosystemic shunt) has replaced ... a retrospective review of percutaneous hepatic vein angioplasty and surgical shunting". Gut. 44 (4): 568-74. doi:10.1136/gut. ...
Glucose tolerance after portacaval shunt in liver cirrhosis. Download Prime PubMed App to iPhone, iPad, or Android ... The aim of the present study was to investigate the effect of surgical portosystemic shunt on plasma glucose and insulin ... Glucose tolerance after portacaval shunt in liver cirrhosis.. Diabete Metab. 1986 Aug; 12(4):197-202.DM ... "Glucose Tolerance After Portacaval Shunt in Liver Cirrhosis." Diabete & Metabolisme, vol. 12, no. 4, 1986, pp. 197-202. ...
The profound clinical disorder remitted completely on surgical correction of the shunt. ... Periodic confusion caused by congenital extrahepatic portacaval shunt. Neil H. Raskin, Dale Bredesen, William K. Ehrenfeld, ... Periodic confusion caused by congenital extrahepatic portacaval shunt. Neil H. Raskin, Dale Bredesen, William K. Ehrenfeld, ... A patient with portal-systemic encephalopathy was found to have congenital portal-systemic shunting due to an extrahepatic ...
... and portacaval shunt; hematological disorders such as aplastic anemia; acute and life-threatening abruptio placentae; hepatic ... These have been reported to date only in hemophilia patients who received the drug after undergoing dental surgical procedures ... Fibrinolytic bleeding may frequently be associated with surgical complications following heart surgery (with or without cardiac ... Symptomatic of such complications is surgical hermaturia (following prostatectomy and nephrectomy) or nonsurgical hematuria ( ...
This technique avoids the general anesthesia and morbidity associated with surgical shunt placement and has been successful in ... Mesocaval shunts are stent grafts placed by interventional radiologists between the mesenteric system, most often the superior ... We propose that mesocaval shunting be offered to this group of patients as it has the potential to decrease portal pressures ... In this paper we review the technique, candidate selection, potential pitfalls and benefits of mesocaval shunt placement. ...
Surgical Portacaval Shunt Medicine & Life Sciences 100% * Glutamate-Ammonia Ligase Medicine & Life Sciences 91% ... The finding of a post-translational increase of GS in muscle following portacaval shunting suggests that, in chronic liver ... The finding of a post-translational increase of GS in muscle following portacaval shunting suggests that, in chronic liver ... The finding of a post-translational increase of GS in muscle following portacaval shunting suggests that, in chronic liver ...
Assessing the patency of liver shunts (eg, surgical portacaval, percutaneous transhepatic). *. Evaluating portal vein patency ...
Different surgical strategies are discussed. Psychiatric exploration gives an insight on development of trichophagia ultimately ... In this case report, the clinical presentation, diagnostic approach, and surgical removal of a large-size bezoar (Rapunzel ... often requiring a surgical approach and commonly associated with an underlying psychiatric disorder. The Rapunzel syndrome is a ... Additionally, extensive collateral circulation with portacaval shunting was present, most likely due to compression of the ...
Some forms of Budd-Chiari may be treated with surgical shunts (such as portacaval shunt) to divert blood flow around the ... TIPS accomplishes the same goal as a surgical shunt but has a lower procedure-related mortality, a factor that has led to a ... Shunts must be placed early after diagnosis for best results.[19] TIPS (transjugular intrahepatic portosystemic shunt) has ... a retrospective review of percutaneous hepatic vein angioplasty and surgical shunting". Gut. 44 (4): 568-74. doi:10.1136/gut. ...
Early shunt surgery with splenorenal or portacaval shunting may be required if repeated endoscopic sclerotherapy fails to ... Types of surgical shunt include nonselective total portosystemic shunts, nonselective partial portosystemic shunts that ... Surgical Care. Portosystemic shunt surgery is the treatment of choice for these patients because the risk of postoperative ... transjugular intrahepatic portosystemic shunting, or surgical shunting. ...
Eck Fistula use Portacaval Shunt, Surgical Eck Ligand use Ephrin-A1 Eck RPTK Ligand use Ephrin-A1 ...
Eck Fistula use Portacaval Shunt, Surgical Eck Ligand use Ephrin-A1 Eck RPTK Ligand use Ephrin-A1 ...
Eck Fistula use Portacaval Shunt, Surgical Eck Ligand use Ephrin-A1 Eck RPTK Ligand use Ephrin-A1 ...
Eck Fistula use Portacaval Shunt, Surgical Eck Ligand use Ephrin-A1 Eck RPTK Ligand use Ephrin-A1 ...
Eck Fistula use Portacaval Shunt, Surgical Eck Ligand use Ephrin-A1 Eck RPTK Ligand use Ephrin-A1 ...
AND INSULIN/GLUCAGON INFUSIONS ON LIVER MORPHOLOGY AND CELL DIVISION AFTER COMPLETE PORTACAVAL SHUNT IN DOGS. The Lancet, 307 ( ... Weil, R and Putnam, CW and Porter, KA and Starzl, TE (1976) Transplantation in children. Surgical Clinics of North America, 56 ... Starzl, TE and Putnam, CW (1976) Surgical approaches to primary and metastatic liver neoplasms. International Journal of ...
Or they may perform a procedure called portacaval shunting. In portacaval shunting, the surgeon creates a new connection ... We are leaders in developing new surgical techniques to make the most effective use of donor organs. Our patients consistently ... medical and surgical care for Asian people with liver disease. ...
A comparison of the ameroid constrictor versus ligation in the surgical managment of single extrahepatic portosystemic shunts. ... portacaval shunt. In: Gilson SD, ed. Self Assessment Colour Review of Small Animal Medicine. London: Manson Publishing Ltd., ... Clinical Surgical Instructor. Department of Small Animal Clinical Sciences. University of Florida. P.O. Box 100126. Gainesville ... Veterinary Surgical Specialists. Inver Grove Heights, Minnesota. 2007 to present. Small Animal Veterinary Surgeon. Twin Cities ...
1. Schroeder ET, Numann PJ, Chamberlain BE: Functional renal failure after portacaval shunt. Ann Int Med 72:923-928, 1970. ... Journal of Surgical Research, 26:249-254, 1979.. 8. Gurll NJ, Holcroft JW, Numann PJ, Reynolds DG, Rhodes RH, Saik RP, Thomas ... Numann held surgical appointments as attending surgeon at Upstate from 1989-2007, was a staff surgeon at the Veterans Affairs ... Surgical Forum, 1975.. 6. Spring-Mills E, Brophy M, Numann PJ: Scanning electron microscopic observations of normal and ...
Liver Shunt A liver shunt is also named a PSS, portosystemic shunt, portacaval shunt or portosystemic vascular anomaly. This ... It is commonly controlled with medication, although surgical methods are used as well. Epileptic seizures are classified both ...
Arteriovenous Shunt, Surgical. Surgical shunt allowing direct passage of blood from an artery to a vein. (From Dorland, 28th ed ... Types of shunt include portacaval, splenorenal, mesocaval, splenocaval, left gastric-caval (coronary-caval), portarenal, ... Portasystemic Shunt, Surgical. Surgical venous shunt between the portal and systemic circulation to effect decompression of the ... Anastomosis, Surgical. Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end ...
Liver Shunt. A liver shunt is also named a PSS, portosystemic shunt, portacaval shunt or portosystemic vascular anomaly. This ... Surgical repair is commonly done for congenital shunts and again the success is dependent on the location and severity of the ... An acquired shunt can develop in any breed and is usually caused by liver problems due to toxins, hepatitis, infections, ... In the case of a shunt, an abnormal blood vessel carries this blood around the liver and dumps the nutrients directly into the ...
A liver shunt is also named a PSS, portosystemic shunt, portacaval shunt or portosystemic vascular anomaly. This abnormality ... Surgical repair is commonly done for congenital shunts and again the success is dependent on the location and severity of the ... The treatment and how well the pet responds are dependent on many things including the location and severity of the shunt. Some ... The pet can be born with the shunt (congenital) or can develop it later (acquired). ...
A liver shunt is also named a PSS, portosystemic shunt, portacaval shunt or portosystemic vascular anomaly. This abnormality ... Surgical repair is commonly done for congenital shunts and again the success is dependent on the location and severity of the ... The treatment and how well the pet responds are dependent on many things including the location and severity of the shunt. Some ... The pet can be born with the shunt (congenital) or can develop it later (acquired). ...
A liver shunt is also named a PSS, portosystemic shunt, portacaval shunt or portosystemic vascular anomaly. This abnormality ... Surgical repair is commonly done for congenital shunts and again the success is dependent on the location and severity of the ... The treatment and how well the pet responds are dependent on many things including the location and severity of the shunt. Some ... The pet can be born with the shunt (congenital) or can develop it later (acquired). ...
A liver shunt is also named a PSS, portosystemic shunt, portacaval shunt or portosystemic vascular anomaly. This abnormality ... Surgical repair is commonly done for congenital shunts and again the success is dependent on the location and severity of the ... The treatment and how well the pet responds are dependent on many things including the location and severity of the shunt. Some ... The pet can be born with the shunt (congenital) or can develop it later (acquired). ...
Liver Shunt in Marion, MS. Till-Newell Animal Hospital is your local Veterinarian in Marion serving all of your needs. Call us ... A liver shunt is also named a PSS, portosystemic shunt, portacaval shunt or portosystemic vascular anomaly. This abnormality ... Surgical repair is commonly done for congenital shunts and again the success is dependent on the location and severity of the ... The treatment and how well the pet responds are dependent on many things including the location and severity of the shunt. Some ...

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