Liver lobe torsion

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The rabbit liver is composed of five lobes -- the right hepatic lobe, caudate and quadrate lobes are single, and the left hepatic one is separated in lateral and medial parts.[1] Liver lobe torsion, also known as hepatic lobe torsion or hepatic infarction, occurs when a lobe of the liver twists about an axis perpendicular to the organ's base of support which causes venous congestion and eventually diffuse necrosis of the lobe.[2] In most cases it is the pendulous caudal process of the caudal lobe, which sits over the right kidney, that twists.[3]

Symptoms

  • Anorexia.
  • Lethargy.
  • Jaundice.
  • Abdominal pain.

Causes

The cause of liver lobe torsion in rabbits is unknown, but predisposing factors are thought to include the following:[4]

  • Surgical or external trauma
  • Congenital absence of hepatic ligaments
  • Dilation of abdominal organs
  • Parasitic and bacterial infection
  • Neoplasia

Diagnosis

Biochemical abnormalities include the following:[2]

  • anaemia
  • increased alanine aminotransferase (ALT)
  • increased aspartate aminotransferase (AST)
  • increased gamma-glutamyl transferase (GGT)

Definitive diagnosis is by radiography or ultrasonography.

Treatment

Treatment is surgical by removing the affected liver lobe. Rabbits with liver lobe torsion will require very good supportive care during the surgery.[2]

Rabbits may also be treated with supportive care only. In a case study by Graham and colleagues, seven out of 16 rabbits were treated with supportive care only, and of these, three rabbits (43%) survived. Supportive care included subcutaneous fluids, pain medication, antimicrobials, supplemental feeding, and prokenetic agents. Surviving rabbits had normal or improved clinicopathologic tests one week to 2 months after the original presentation and had multiple episodes of recurrent GI stasis within the first 1 to 2 months following hospitalization.[4]

Experiences

The following articles are anecdotal experiences of owners with rabbits that had liver lobe torsion.

The following are a few scientific case studies.

Further reading

References

  1. Stamatova-Yovcheva K et al. (2012). Anatomical Macromorphological Features of the Domestic Rabbits (Oryctolagus Cuniculus)
  2. 2.0 2.1 2.2 Varga, M. (2013). Textbook of rabbit medicine. (2nd ed.).
  3. Harcourt-Brown, F. (n.d.). Liver lobe torsion. Retrieved 12 March 2016 from https://www.harcourt-brown.co.uk/articles/sudden-or-unexpected-death/differential-diagnosis-list/liver-lobe-torsion
  4. 4.0 4.1 Graham, JE et al. (2014). Liver Lobe Torsion in Pet Rabbits: Clinical Consequences, Diagnosis, and Treatment. Retrieved 14 Mar 2017 from https://www.researchgate.net/publication/261917236_Liver_Lobe_Torsion_in_Pet_Rabbits_Clinical_Consequences_Diagnosis_and_Treatment