The hilar perivenous hyperechoic triangle as a sign of acute splenic torsion in dogs

Abstract

Diagnosis of acute primary splenic torsion is challenging. The ultrasonographic appearance of this condition has been described, but other splenic diseases, such as diffuse infarction because of thrombosis, can appear very similar. We describe an additional ultrasonographic sign of acute splenic torsion; a triangular hyperechoic area at the hilus between the veins and the splenic parenchyma that is continuous with the hyperechoic mesentery. In a group of animals where acute splenic torsion was part of the ultrasound report differential diagnosis, we compared findings in dogs with torsion with findings in dogs with other splenic conditions. The presence of a hilar hyperechoic perivenous triangle was significantly associated with splenic torsion (P=0.005). We speculate that this sign is associated with torsion because of the secondary severe, diffuse splenic enlargement. Although not pathognomonic, this sign could be used to more accurately diagnose splenic torsion in light of other findings consistent with this condition.