한국임상수의학회지 (Journal of Veterinary Clinics)

  • 제31권6호
  • /
  • Pages.531-534
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  • 2014
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  • 1598-298X(pISSN)
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  • 2384-0749(eISSN)
한국임상수의학회 (The Korean Society of Veterinary Clinics)
권호 표지

개에서의 횡격막 탈장에 의한 간외담도폐색

Extrahepatic Biliary Obstruction Secondary to Traumatic Diaphragmatic Hernia in Dog

  • 윤영민 (경상대학교 동물의학연구소) ;
  • 정동인 (경상대학교 동물의학연구소) ;
  • 연성찬 (경상대학교 동물의학연구소) ;
  • 이희천 (경상대학교 동물의학연구소)
  • Yoon, Young-Min (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Jeong, Dong-In (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Yeon, Seong-Chan (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University) ;
  • Lee, Hee-Chun (Institute of Animal Medicine, College of Veterinary Medicine, Gyeongsang National University)
  • 심사 : 2014.12.08
  • 발행 : 2014.12.31
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초록

3년령의 암컷 사냥견이 구토, 호흡곤란, 식욕부진을 주증으로 내원 하였다. 환자는 내원 2주 전 멧돼지에 받힌 병력이 있었다. 환자는 방사선사진상 횡격막 탈장 소견, 초음파 검사상 확장된 담도계가 확인되었다. 탐색적 개복술 시 오른쪽 횡격막의 손상이 확인되었고 흉강내에서 일부 간엽과 소장분절, 확장된 담도계를 확인하였다. 수술적 처치로 흉강내 위치하는 복강 장기들을 환원시키고 횡격막 탈장 교정술을 실시하였으며 이후 임상증상, 방사선사진과 초음파 검사 소견은 모두 정상적인 수준으로 회복되었다. 이를 토대로 횡격막 탈장에 의해 속발된 간외담도계폐색으로 진단하였다. 본 증례는 횡격막 탈장에 의해 속발된 간외담도계폐색이 발생한 증례 보고이다.

A 3-year-old intact mixed hunting dog was referred to Gyeongsang Animal Medical Center with the clinical signs of vomiting, dyspnea, anorexia. The dogs had traumatic history that wounded at abdominal wall during the wild boar hunting 2 week ago. The dogs was diagnosed as extrahepatic biliary tract obstruction (EHBO) secondary to traumatic hernia. Diagnosis was based on radiographic features of a diaphragmatic hernia on survey radiography, dilated bile duct in abdominal ultrasonography and complete recovery due to the return of displaced organs into the peritoneal cavity and repair of the diaphragmatic rent. Diagnostic imaging and surgical intervention may result in a favorable outcome in dog with post hepatic obstruction secondary to diaphragmatic hernia. This case emphasizes the strangulation of bile duct by diaphragmatic rupture could be the cause of EHBO.

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참고문헌

  1. Aronsen K, Hägerstrand I, Norden J. Enzyme studies in dogs with extra-hepatic biliary obstruction. Scand J Gastroenterol 1968; 3: 355-368. https://doi.org/10.3109/00365526809180130
  2. Blackbourne LH, Earnhardt RC, Sistrom CL, Abbitt P, Jones R. The sensitivity and role of ultrasound in the evaluation of biliary obstruction. Am Surg 1994; 60: 683-690.
  3. Cornell K, Jakovljevic S, Waters D, Prostredny J, Salisbury S, Denicola D. Extrahepatic biliary obstruction secondary to diaphragmatic hernia in two cats. J Am Anim Hosp Assoc 1993; 29: 502-507.
  4. Denning DA, Ellison EC, Carey LC. Preoperative percutaneous transhepatic biliary decompression lowers operative morbidity in patients with obstructive jaundice. Am J Surg 1981; 141: 61-65. https://doi.org/10.1016/0002-9610(81)90013-1
  5. Fahie MA, Martin RA. Extrahepatic biliary tract obstruction: a retrospective study of 45 cases (1983-1993). J Am Anim Hosp Assoc 1995; 31: 478-482. https://doi.org/10.5326/15473317-31-6-478
  6. Hyun C. Radiographic diagnosis of diaphragmatic hernia: review of 60 cases in dogs and cats. J Vet Sci 2004; 5: 157-162.
  7. Kryszewski A, Neale G, Whitfield J, Moss D. Enzyme changes in experimental biliary obstruction. CCA 1973; 47: 175-182.
  8. Lehner C, McAnulty J. Management of extrahepatic biliary obstruction: a role for temporary percutaneous biliary drainage. Compend Contin Educ Vet 2010; 32: E1-E10. https://doi.org/10.1080/01580370903534223
  9. Matthiesen D, Rosin E. Common bile duct obstruction secondary to chronic fibrosing pancreatitis: treatment by use of cholecystoduodenostomy in the dog. J Am Vet Med Assoc 1986; 189: 1443.
  10. Mayhew P, Holt D, McLear R, Washabau R. Pathogenesis and outcome of extrahepatic biliary obstruction in cats. J Small Anim Pract 2006; 43: 247-253.
  11. Minihan AC, Berg J, Evans KL. Chronic diaphragmatic hernia in 34 dogs and 16 cats. J Am Anim Hosp Assoc 2004; 40: 51-63. https://doi.org/10.5326/0400051
  12. Neer TM. A review of disorders of the gallbladder and extrahepatic biliary tract in the dog and cat. J Vet Intern Med 1992; 6: 186-192. https://doi.org/10.1111/j.1939-1676.1992.tb00335.x
  13. Nyland TG, Gillett NA. Sonographic evaluation of experimental bile duct ligation in the dog. Vet Radiol 2005; 23: 252-260.
  14. Richard WN, Guillermo C. Hepatobiliary and Exocrine Pancreatic Disorders. In: Small animal internal medicine, 4th ed. St.Louis, Missouri 63146: Mosby, 2009: 554-555.
  15. Schmiedt CW, Tobias KM, Stevenson MAMC. Traumatic diaphragmatic hernia in cats: 34 cases (1991-2001). J Am Vet Med Assoc 2003; 222: 1237-1240. https://doi.org/10.2460/javma.2003.222.1237
  16. Stephen JB, Robert G, Sherding. Diseases of the Liver and Biliary Tract. In: Saunders manual of small animal practice, 3rd ed. St.Louis, Missouri 63146: Saunders, 2006: 807.
  17. Sullivan M, Lee R. Radiological features of 80 cases of diaphragmatic rupture. J Small Anim Pract 1989; 30: 561-566. https://doi.org/10.1111/j.1748-5827.1989.tb01473.x
  18. Wilson GP, Newton CD, Burt JK. A review of 116 diaphragmatic hernias in dogs and cats. J Am Vet Med Assoc 1971; 159: 1142-1145.
  19. Zeman R, Taylor K, Rosenfield A, Schwartz A, Gold J. Acute experimental biliary obstruction in the dog: sonographic findings and clinical implications. Am J Roentgenol 1981; 136: 965-967. https://doi.org/10.2214/ajr.136.5.965