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Tension Pneumothorax in a Dog with Diaphragmatic Hernia

횡격막허니아에 병발한 긴장성기흉 1례

  • Kim, Hyunseok (Veterinary Medical Teaching Hospital, the Research Institute for Veterinary Science and BK 21 PLUS program of College of Veterinary Medicine, Seoul National University) ;
  • Yun, Soo-kyung (Veterinary Medical Teaching Hospital, the Research Institute for Veterinary Science and BK 21 PLUS program of College of Veterinary Medicine, Seoul National University) ;
  • Son, Won-gyun (Veterinary Medical Teaching Hospital, the Research Institute for Veterinary Science and BK 21 PLUS program of College of Veterinary Medicine, Seoul National University) ;
  • Jang, Min (Veterinary Medical Teaching Hospital, the Research Institute for Veterinary Science and BK 21 PLUS program of College of Veterinary Medicine, Seoul National University) ;
  • Hwang, Hyeshin (Veterinary Medical Teaching Hospital, the Research Institute for Veterinary Science and BK 21 PLUS program of College of Veterinary Medicine, Seoul National University) ;
  • Jo, Sang-min (Veterinary Medical Teaching Hospital, the Research Institute for Veterinary Science and BK 21 PLUS program of College of Veterinary Medicine, Seoul National University) ;
  • Shin, Chi Won (Veterinary Medical Teaching Hospital, the Research Institute for Veterinary Science and BK 21 PLUS program of College of Veterinary Medicine, Seoul National University) ;
  • Kim, Wan Hee (Veterinary Medical Teaching Hospital, the Research Institute for Veterinary Science and BK 21 PLUS program of College of Veterinary Medicine, Seoul National University) ;
  • Yoon, Junghee (Veterinary Medical Teaching Hospital, the Research Institute for Veterinary Science and BK 21 PLUS program of College of Veterinary Medicine, Seoul National University) ;
  • Lee, Inhyung (Veterinary Medical Teaching Hospital, the Research Institute for Veterinary Science and BK 21 PLUS program of College of Veterinary Medicine, Seoul National University)
  • 김현석 (서울대학교 수의과대학 동물병원, 수의과학연구소.BK21 PLUS) ;
  • 윤수경 (서울대학교 수의과대학 동물병원, 수의과학연구소.BK21 PLUS) ;
  • 손원균 (서울대학교 수의과대학 동물병원, 수의과학연구소.BK21 PLUS) ;
  • 장민 (서울대학교 수의과대학 동물병원, 수의과학연구소.BK21 PLUS) ;
  • 황혜신 (서울대학교 수의과대학 동물병원, 수의과학연구소.BK21 PLUS) ;
  • 조상민 (서울대학교 수의과대학 동물병원, 수의과학연구소.BK21 PLUS) ;
  • 신지원 (서울대학교 수의과대학 동물병원, 수의과학연구소.BK21 PLUS) ;
  • 김완희 (서울대학교 수의과대학 동물병원, 수의과학연구소.BK21 PLUS) ;
  • 윤정희 (서울대학교 수의과대학 동물병원, 수의과학연구소.BK21 PLUS) ;
  • 이인형 (서울대학교 수의과대학 동물병원, 수의과학연구소.BK21 PLUS)
  • Received : 2016.03.14
  • Accepted : 2016.06.13
  • Published : 2016.08.31

Abstract

A 1.86 kg, 3-year-old, female, Maltese was presented to the Veterinary Medical Teaching Hospital of Seoul National University after being hit by a car. The patient was diagnosed with urinary bladder rupture, diaphragmatic hernia and fracture of ilium, tibia and fibula. Repair surgery was performed after stabilizing treatment. During the surgery, hypoxia was identified and it worsened after positive pressure ventilation (partial pressure of oxygen in arterial blood ($PaO_2$): 52 mmHg, pulse oximetry ($SpO_2$): 87%, arterial hemoglobin oxygen saturation ($SpO_2$): 85.8%). In addition to hypoxia, blood pressure decreased to 30 mmHg. Positive pressure ventilation was discontinued because hypoxia and hypotension were aggravated. After suturing the diaphragm, air was withdrawn to form negative pressure within the thorax. However, negative pressure was not attained despite continuous withdrawal of air. A thoracostomy tube was placed because tension pneumothorax was strongly suspected. The patient recovered through close monitoring with the tube for 3 days. Due to limitation of evaluation of the lung, predicting occurrence of tension pneumothorax is difficult in patient of diaphragmatic hernia. Therefore, it is recommended that indicators of tension pneumothorax should be closely monitored during diagnosis and repair procedures of diaphragmatic hernia.

Keywords

References

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