Journal of Veterinary Clinics (한국임상수의학회지)

The Korean Society of Veterinary Clinics (한국임상수의학회)
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Pelvic Symphyseal Distraction Osteotomy for Constipation Management Secondary to Pelvic Stenosis

골반강 협착증으로 인해 발생한 변비를 가진 고양이에서의 골반강 확장술을 이용한 치료 증례

  • Oh, Kwang-Seon (College of Veterinary Medicine, Chonbuk National University) ;
  • Choi, Sung-Jin (Department of Veterinary Surgery, The University of Tokyo) ;
  • Kim, Nam-Soo (College of Veterinary Medicine, Chonbuk National University) ;
  • Kim, Min-Su (College of Veterinary Medicine, Chonbuk National University) ;
  • Lee, Ki-Chang (College of Veterinary Medicine, Chonbuk National University) ;
  • Lee, Hae-Beom (College of Veterinary Medicine, Chungnam National University)
  • Accepted : 2014.12.08
  • Published : 2014.12.31
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Abstract

A 7-year-old neutered male Korean domestic short-haired cat was referred to our clinic to treat constipation which had persisted for 6 months. The rectal examination revealed narrowing of the right lateral portion of the pelvic canal. A reduced pelvic canal diameter by pelvic fracture malunion was revealed on radiography. The pelvic canal diameter ratio measured from preoperative was 0.68. Based on rectal and radiographic examinations, constipation caused by pelvic canal narrowing was confirmed. Pelvic symphyseal distraction-osteotomy and iliac wedge osteotomy were performed. An iliac osteotomy of the ilium was performed to ease the pelvic symphyseal distraction. After the symphysis was split longitudinally, pelvic symphyseal distraction was maintained by using a spacer made of poly-methyl-methacrylate. The osteotomy of the ilium was fixed using a bone plate and screws. Increased pelvic canal diameter was confirmed on post-operative radiography and the postoperative pelvic canal diameter ratio was 0.91. The patient received antibiotics, NSAIDs, crystalloids and Lactulose for post-operative care. The cat recovered normal defecation abilities and did not have constipation at one week postoperatively. No episodes of constipation persisting longer than 6 months have been reported by owners in previous studies. Pelvic symphyseal distraction osteotomy and iliac wedge osteotomy may prove to be a useful surgical procedure to treat pelvic canal stenosis that is caused by pelvic fracture malunion.

7살 중성화된 수컷 한국집 고양이가 6개월동안 지속된 변비를 주증으로 본원에 내원하였다. 직장검사에서 골반강의 우측 외측부분의 좁아짐을 보였고, 방사선검사에서는 골반골절의 부정유합으로 인한 골반강의 협착을 확인할 수 있었다. 골반강 직경 비율은 0.68이었다. 직장검사와 방사선검사를 기반으로 골반강 협착으로 인한 변비로 진단하였다. 그래서 골반결합을 절골하여 골반강 확장술을 시행하였고 이를 용이하게 하기 위하여 장골 절골술도 함께 시행하였다. 확장된 골반강을 유지하기 위하여 골반결합 사이에 폴리메칠메타크릴레이트를 성형하여 구조물로 삽입하였다. 절골 한 장골은 뼈판과 나사를 이용하여 다시 고정시켜주었다. 방사선 검사에서 술 후 골반강 직경 비율은 0.91로 증가했음을 알 수 있었다. 술 후 처치로는 항생제, 진통소염제, 락툴로오스경구제 투여와 함께 수액요법을 시행하였다. 환자는 골반강 확장술 후 일주일부터 정상적인 배변을 보였고, 그 이후 6개월동안 재발은 없었다. 이 증례를 바탕으로 골반강 확장술은 골반골절의 부정유합으로 인한 골반강 협착에 따라 발생한 변비에서 유용한 치료법으로 사료된다.

Keywords

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