Diagnosis and medical management of liver shunts
Portosystemic shunts can be diagnosed via several methods including:
1) Abdominal ultrasound
2) Nuclear scintigraphy
3) Abdominal CT scan
4) Cranial mesenteric arteriograms
Abdominal ultrasound is considered the least invasive. However, it only has approximately 70% sensitivity (ability to diagnose a portosystemic shunt when present). Abdominal CT scan and cranial mesenteric arteriograms require general anesthesia and are costly, but they provide the anatomy of the shunting vessel. Nuclear scintigraphy is considered the gold standard (best test available) test and it is non-invasive. Nonetheless, patients become radioactive for 12-24 hours. This may require an overnight stay in the hospital.
Medical management of liver shunts is done via controlling clinical signs. This is best attained by using a combination of diet, antibiotics and laxatives. Treatment is tailored to each individual patient.