한국임상수의학회지 (Journal of Veterinary Clinics)

  • 제30권2호
  • /
  • Pages.138-141
  • /
  • 2013
  • /
  • 1598-298X(pISSN)
  • /
  • 2384-0749(eISSN)
한국임상수의학회 (The Korean Society of Veterinary Clinics)
권호 표지

개에서 장 기종의 초음파적 특징 1례

Ultrasonographic Findings of Pneumatosis Intestinalis in a Dog

  • 송유미 (충남대학교 수의과대학 영상진단교실) ;
  • 이정양 (충남대학교 수의과대학 영상진단교실) ;
  • 이정우 (충남대학교 수의과대학 영상진단교실) ;
  • 정우창 (충남대학교 수의과대학 영상진단교실) ;
  • 이영원 (충남대학교 수의과대학 영상진단교실) ;
  • 최호정 (충남대학교 수의과대학 영상진단교실)
  • Song, Yu-Mi (College of Veterinary Medicine, Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Lee, Jeong-Yang (College of Veterinary Medicine, Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Lee, Jung-Woo (College of Veterinary Medicine, Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Jeung, Woo-Chang (College of Veterinary Medicine, Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Lee, Young-Won (College of Veterinary Medicine, Research Institute of Veterinary Medicine, Chungnam National University) ;
  • Choi, Ho-Jung (College of Veterinary Medicine, Research Institute of Veterinary Medicine, Chungnam National University)
  • 심사 : 2013.04.16
  • 발행 : 2013.04.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

4개월령의 수컷 잡종견이 교통사고에 의한 외상, 기립불능, 혼수, 복부통증으로 내원하였다. 방사선 검사에서 복수, 장 확장, 우측 장골 골절, 소심증이 확인되었다. 복부 초음파 검사에서 내강에 무 에코의 액체와 장벽 점막 내 가스를 함유하고 있는 심하게 확장된 소장 분절이 관찰되었다. 이러한 초음파적 특징은 장 기종 (pneumatosis intestinalis)에서 관찰되며, 이것은 외상에 따른 장 분절의 혈관 혈류 이상에 의한 것으로 의심된다. 환축이 폐사 한 후 부검한 결과, 일부 장 분절이 요추하 근육에 의해 교액되어 변색 및 괴사한 상태임을 확인하였다. 초음파는 장벽 내 에코가 있는 가스를 확인하여 장 기종을 진단할 수 있는 유용한 수단이다.

A 4-month-old, intact male mongrel dog was presented with trauma (hit by car), astasia, stupor and abdominal pain. Radiographic findings were peritoneal effusion, intestinal dilation, right iliac fracture, and microcardia. Abdominal ultrasonography revealed severely, dilated small intestine containing anechoic fluid in lumen and intramural gas within the wall. The sonographic finding suggested pnematosis intestinalis (PI), and vascular compromise of bowel loop by trauma was strongly suspected. After the dog was dead, postmortem examination revealed discolored and necrotized small intestine strangulated by sublumbar muscle. The detection of echogenic gas bubbles in the wall of bowel using ultrasound may be helpful in detecting PI.

키워드

참고문헌

  1. Anderson GR, Greary JC. Canine pneumatosis coli. J Am Anim Hosp Assoc 1973; 9: 354-357.
  2. Aste G, Boari A, Guglielmini C. What's your diagnosis? J Am Vet Med Assoc 2005; 227: 1407-1408. https://doi.org/10.2460/javma.2005.227.1407
  3. Choi JH, Kim TE, Kim HW, Seo JM, Kim ME, Yoon JH. Pneumatosis coli in a dog. Journal of Veterinary Clinics 2009; 26: 298-302.
  4. Danse EM, Van Beers BE, Gilles A, Jacquet L. Sonographic detection of intestinal pneumatosis. European Journal of Ultrasound 2000; 11: 201-203. https://doi.org/10.1016/S0929-8266(00)00088-4
  5. Degner DA. Pneumatosis coli in a dog. Can Vet J 1992; 33: 609-611.
  6. Fischetti AJ, Saunders HM, Drobatz KJ. Pneumatosis in canine gastric dilatation-volvulus syndrome. Vet Radiol Ultrasound 2004; 45: 205-209. https://doi.org/10.1111/j.1740-8261.2004.04034.x
  7. Goske MJ, Goldblum JR, Applegate KE, Mitchell CS, Bardo D. The "circle sign": a new sonographic sign of pnemoatosis intesinalis-clincal, pathologic and experimental findings. Pediatr Radiol 1999; 29: 530-535. https://doi.org/10.1007/s002470050638
  8. Ho LM, Paulson EK, Thompson WM. Pneumatosis intestinalis in the adult: benign to life-threatening causes. Am J Roent 2007; 188: 1604-1613. https://doi.org/10.2214/AJR.06.1309
  9. Kawano S, Tanaka H, Daimon Y, Niizuma T, Terada K, Kataoka N, Iwamura Y, Aoyama K. Gastric pneumatosis associated with duodenal stenosis and malrotation. Pediatr Radiol 2001; 31: 656-658. https://doi.org/10.1007/s002470100514
  10. Kernagis LY, Levine MS, Jacobs JE. Pneumatosis intestinalis in patients with ischemia: Correlation of CT findings with viability of bowel. Am J Roent 2003; 180: 733-736. https://doi.org/10.2214/ajr.180.3.1800733
  11. Kim WY, Kim IO, Kim WS, Yeon KM, Kim GI, Lee SW, Suh JS, Choi HY, Chang KJ. Sonographic findings in a Model of ischemia-induced necrotizing enterocolitis with pathological correlations. Ivest Radial 2007; 42: 312-318. https://doi.org/10.1097/01.rli.0000258681.14275.19
  12. Knechtle SJ, Davidoff AM, Rice RP. Pneumatosis intestinalis: surgical management and clinical outcome. Ann surg 1990; 212: 160-165. https://doi.org/10.1097/00000658-199008000-00008
  13. Lang LG, Greatting HH, Spaulding KA. Imaging diagnosisgastric pneumatosis in a cat. Vet Radiol Ultrasound 2011; 52: 658-660. https://doi.org/10.1111/j.1740-8261.2011.01834.x
  14. Morris EL. Pneumatosis coli in a dog. Vet Radiol Ultrasound 1992; 33: 154-157. https://doi.org/10.1111/j.1740-8261.1992.tb01437.x
  15. Pai HJ, Wang CS, Hsieh CC, Wang WK, Yang BY. Pneumatosis intestinalis: a rare manifestation of acute appendicitis. J Emerg Med 2009; 37: 127-130. https://doi.org/10.1016/j.jemermed.2007.02.058
  16. Pear BL. Pneumatosis intestinalis: a review. Radiology 1998; 207: 13-19. https://doi.org/10.1148/radiology.207.1.9530294
  17. Russell NJ, Tyrrell D, Irwin PJ, Beck C. Pneumatosis coli in a dog. J Am Anim Hosp Assoc 2008; 44: 32-35. https://doi.org/10.5326/0440032
  18. Sato M, Ishida H, Konno K, Komatsuda T, Naganuma H, Hamashima Y, Ohnami Y, Watanabe S, Ishida J Sonography of pneumatosis cystoides intesinalis. Adom Imaging 1999; 24: 559-561. https://doi.org/10.1007/s002619900562
  19. Vernacchia FS, Jeffrey RB, Laing FC, Wing VW. Sonographic recognition of pneumatosis intestinalis. Am J Radiol 1985; 145: 51-52.