Surgical Correction of Peritoneopericardial Diaphragmatic Hernia with Hepatic Necrosis in a Himalayan Cat

히말라얀 고양이에서 간괴사를 동반한 복막심낭횡격막 허니아의 외과적 치료

  • Kim, Joon-young (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Jeong, Soon-wuk (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Park, Bo-yeon (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Go, Hiw-gon (Bak-san Animal Hospital) ;
  • Yoon, Hun-young (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Jeong, Man-bok (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Han, Hyun-jung (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • Min Hwang (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University) ;
  • No, Byung-kuk (Department of Veterinary Surgery, College of Veterinary Medicine, Konkuk University)
  • Published : 2004.03.01

Abstract

A five months old, female Himalayan cat was referred to the Veterinary Medical Teaching Hospital at Konkuk University, because of suspecting peritoneopericardial diaphragmatic hernia (PPDH). After consecutive examination, the patient was diagnosed as PPDH and hepatic dysfunction. In spite of medical therapy for a month, the serum chemistry profiles for liver enzymes (aspartate transferase: 469 U/L, alanine transferase: above analysis, gamma-glutamyl transferase: above analysis) did not decrease to the normal range. In operation, some of liver was necrotized and was adhesive to diaphragm, these were gently dissected from thoracic structures, and resected. After debriding, the edges of the defect of diaphragm were closed with a simple continuous suture pattern. One month after operation, the cat had normal condition, recovery was uncomplicated, and the serum chemistry profiles for liver enzymes decrease to the normal range.

5년령의 암컷 히말라얀 고양이가 복막심낭횡격막 허니아가 의심되어서 건국대학교 수의과대학 부속 동물병원에 내원하였다. 일련의 검사를 실시한 후 환자는 복막심낭횡격막 허니아와 간기능 부전이 확진되었다. 그 후 한 달간의 약물치료에도 불구하고, 혈청화학검사에서 간효소 (aspartate transferase, alanine transferase, gamma-glutamyl transferase) 수치는 정상범위로 내려 가지 않았다. 이 환자는 수술 중에 간 일부가 횡격막에 유착되어서 괴사가 일어난 것이 발견되었고, 유착되고 괴사된 간 조직은 횡격막에서 조심스럽게 분리하여 절제하였다. 횡격막은 괴사된 부분을 잘 정리하고 난 뒤에 손상된 횡격막 부분을 simple continuous suture pattern으로 봉합하였다. 수술 후 한 달 뒤 환축은 정상적인 상태를 보였고 다른 복합증 없이 회복되었다. 그리고 혈청화학 수치 중 간효소 수치도 정상 범위로 떨어졌다.

Keywords

References

  1. J Am Vet Radiol Soc v.110 Congenital peritoneopericardial diaphragmatic hernia in a cat Barret,R.B.
  2. Semin Vet Med Surg (small Anim) v.1 Diaphramatic hernia: anesthetic con-siderations Bellah,J.R.
  3. Textbook of Small Animal Surgery(3rd ed.) Diaphragmatic, Pericardial, and Hiatal Hernia, Liver and Billaty System Douglas,S.
  4. Vet Radiol v.21 Congenital Peritoneopericardial diaphragmatic hernia in the dog and cat: a literature review and 17 additional case histories Evans,S.M.;Biery,D.N.
  5. J Am Anim Hosp Assoc v.28 congenital peritoneal pericardial diaphragmatic hernia and portocaval shunt in a cat Lunney,J.
  6. J Am Anim Hosp Assoc v.30 Chylothorax associated with lung lobe torsion and a Peritoneopericardial diaphragmatic hernia in a cat Kerpsack,S.J.
  7. Small Animal Surgery(2nd ed.) Surgery of teh Liver, Peritoneopericardial Diapharagmatic Herina Fossum,T.W.
  8. Anat Rec v.110 Pericardio-peritoneal hernia in mammals with a description in a domestic cat Reed,C.A.
  9. J Am Anim Hosp Assoc v.21 Congenital Peritoneopericardial dia-phragmatic hernia in a dog Schulman,A.J.
  10. Vet Med v.3 surgical repair of a congenital pericardial diaphragmatic hernia Wright,R.P.;Wright,r.;Scott,R.
  11. J Am Anim Hosp Assoc v.28 A technique for surgical correction of peritoneal pericardial diaphragmatic hernia on dogs and cats Wallace,J.;Mullen,H.S.;Lesser,M.B.
  12. J Am Vet Med Assoc v.173 Pericardiodiaphragmatic hernia in a dog Weitz,J.;Tilly,L.P.;Moldoff,D.