• 한국임상수의학회:학술대회논문집
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• 한국임상수의학회 2009년도 춘계학술대회
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• pp.308-308
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• 2009

• 대한수의학회지
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• 제59권3호
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• pp.171-173
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• 2019

Two dogs presented with vomiting and head pressing. In both dogs, a large vessel was revealed in computed tomography (CT) angiography, which was found to leave the portal vein (PV) cranial to the splenomesenteric confluence and enter the pre-hepatic caudal vena cava cranial to the right renal vein. The flow of portal blood to the liver was not identified. Based on CT angiography, the dogs were suspected to have congenital PV aplasia with portocaval shunting. Diagnostic imaging of potential malformations for PV continuation should be conducted before attempting shunt closure.

• 대한약학회:학술대회논문집
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• 대한약학회 2003년도 Proceedings of the Convention of the Pharmaceutical Society of Korea Vol.1
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• pp.308.1-308.1
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• 2003

We underwent this study to know correlation between the amount of portosysternic shunt/hepatic fibrosis and bioavailability parameters such as AUC, Cmax, Tmax and t1 /2 of high extraction ratio drug, propranolol, in CCl4-induced liver cirrhosis model of rats. This study describes the bioavaility study of propranolol(5 mg/kg), Shunt Index using thallium-201 per rectum scintigraphy to to measure the amount of portosystemic shunt indirectly and intrahepatic hydroxyproline content performed in the CCl4-induced liver cirrhosis model of rats. (omitted)

• 한국임상수의학회지
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• 제41권2호
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• pp.95-100
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• 2024

A 6-year-old neutered male Poodle with a body weight of 2.7 kg was diagnosed with a congenital extrahepatic portoazygos shunt presented with progressive hepatic encephalopathy. Five days after surgical attenuation, the patient showed post-attenuation neurological signs (PANS) such as generalized tonic-clonic seizure, dull mentation, and tremor. PANS were successfully managed with antiepileptic drugs, but third-space fluid accumulation (ascites and peripheral edema) and phlebectasia were newly identified, suggesting marked portal hypertension (PHT). Telmisartan, spironolactone, carvedilol, and prednisolone were sequentially administered. Three months after surgery, both abnormal clinicopathological values such as anemia and hypoalbuminemia, and clinical signs completely resolved. Herein, we report successful management strategies for PANS and PHT in a dog following surgical attenuation of a congenital portoazygos shunt.

• Clinical and Experimental Pediatrics
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• 제56권11호
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• pp.500-504
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• 2013

Here we present the case of an 11-year-old female patient diagnosed with Caroli syndrome, who had refractory esophageal varices. The patient had a history of recurrent bleeding from esophageal varices, which was treated with endoscopic variceal ligation thrice over a period of 2 years. However, the bleeding was not controlled. When the patient finally visited the Emergency Department, the hemoglobin level was 4.4 g/dL. Transhepatic intrajugular portosystemic shunt was unsuccessful. Subsequently, the patient underwent percutaneous transhepatic variceal obliteration. Twenty hours after this procedure, the patient complained of aphasia, dizziness, headache, and general weakness. Six hours later, the patient became drowsy and unresponsive to painful stimuli. Lipiodol particles used to embolize the coronary and posterior gastric veins might have passed into the systemic arterial circulation, and they were found to be lodged in the brain, kidney, lung, and stomach. There was no abnormality of the portal vein on portal venography, and blood flow to the azygos vein through the paravertebral and hemiazygos systems was found to drain to the systemic circulation on coronary venography. Contrast echocardiography showed no pulmonary arteriovenous fistula. Symptoms improved with conservative management, and the esophageal varices were found to have improved on esophagogastroduodenoscopy.

• 한국임상수의학회지
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• 제20권4호
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• pp.508-515
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• 2003

A 4-month-old 5.7 kg male Golden retriever with history of seizure, depression, lethargy and anorexia was referred to Veterinary Medical Teaching Hospital, Chungbuk National University. Hematologic examination revealed microcytosis and nonregenerative anemia. Serum chemical values showed increased serum ammonia (423 $\mu$mol/L), ALP (1101 U/L), r-GTP (13.9 U/L) and CPK (1454 U/L), and decreased total protein (4.9 g/dl) and BUN (1.6 mg/dl). Microhepatia was shown in survey abdominal radiographs. Color doppler ultrasonographic examination revealed dilated tortuous vein with turbulent flow within liver parenchyma. Intraoperative jejunoportography and intraoperative ultrasonography confirmed the location and size of single intrahepatic shunt vessel in the left medial liver lobe. Also, the anomalous vessel entering the caudal vena cava was identified beneath the diaphragm. The shunting vessel was ligated with using an Ameroid constrictor. General conditions, hematologic and serum chemical values resolved gradually after surgery. One month after surgery abdominal radiograph showed normal gastric axis and it was consistent whit the normal size liver. Normal echogenecity of liver and enlargement of portal vein were shown in ultrasonography. It is assumed that survey radiography and ultrasonography are useful for diagnosis of single intrahepatic shunt in a dog and especially jejunoportography vein portography and intraoperative ultrasonography are suitable for confirmation of the anatomic location and size of the shunting vessels.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제22권1호
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• pp.80-85
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• 2019

Purpose: Abernethy malformation is a rare condition, which was first described in 1793 as a congenital extrahepatic porto-systemic shunt (CEPS) directing splanchnic blood flow into the inferior vena cava. Eighty cases have been published so far that reported CEPS, while in Korea, very few cases have been reported. Through this study, we present 6 cases of patients diagnosed with CEPS at Samsung Medical Center and compare these with other such cases published in France and China. Methods: We reviewed clinical, laboratory, and imaging data of 6 children with CEPS in our pediatric clinic between 2004 and 2017. Results: A total of 6 children with CEPS was included in this study, namely, one with type 1a, two with type 1b, and three with type 2 CEPS. The most common presenting symptom was gastrointestinal bleeding (50.0%). Therapeutic interventions included shunting vessel ligation (16.7%) in type 2 CEPS and liver transplantation (16.7%) in type 2 CEPS patient with suddenly developed hepatic encephalopathy. Conclusion: There is no consensus guideline for the optimal management of patients with CEPS. Large-sample studies regarding CEPS are needed to evaluate the characteristics of patients with CEPS and determine the treatment guideline for CEPS.

• 한국임상수의학회지
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• 제41권1호
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• pp.43-48
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• 2024

A two-year-old, intact female Golden Retriever had previously been diagnosed with a portosystemic shunt (PSS) during an ultrasonographic examination at a local animal hospital. The serum biochemistry revealed elevated liver enzymes and bile acid levels. The abdominal radiographic examination revealed mild serosal detail loss and microhepatica, while abdominal ultrasonography revealed mild ascites and high-velocity flow to the caudal vena cava (CVC) suspected as a PSS. The gallbladder was not observed within the hepatic parenchyma during ultrasonography. Computed tomography (CT) revealed an absent gallbladder and dilation of the common bile duct (CBD). Dilations of the gastroduodenal, splenic, colic and renal veins were also observed. A dilated left phrenico-abdominal vein that entered the CVC was previously misinterpreted as a PSS on the ultrasound examination. Based on the imaging examinations, the dog was diagnosed with congenital gallbladder agenesis associated CBD dilation.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제11권1호
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• pp.56-59
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• 2008

저자들은 간의 거대 종괴와 심방 중격 결손으로 수술을 받았던 환아에서 복부 CT와 간 조직 검사를 통해 확인된 Abernethy 기형 2형 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.328-330
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• 2002

Large balloon angio catheter is used for Percutaneous Transluminal Angioplsty(TPA) of the iliac, femoral and renal arteries as well as after Transjugular Intrahepatic portosystemic shunt(TIPS). The use of angioplasty balloon filled with liquid form of radioisotope reduces the rate of restenosis after PTA. The purpose of this study was to evaluate the absorbed dose to the target vessels from various sized large balloon filled with liquid form of Ho-166-DTPA. Four balloons of balloon dilatation catheters evaluated were 5, 6, 8 and 10 mm in diameter. GafChromic film was used for the estimation of the absorbed dose near the surface of the balloon catheters. Absorbed dose rates are plotted in units of Gy/min/GBq/ml as a function of radial distance in mm from the surface of balloon. The absorbed dose rate was 1.1, 1.6, 2.2 and 2.3 Gy/min/GBq/ml at a balloon surface, 0.3, 0.4, 0.5 and 0.6 Gy/min/GBq/ml at 1 mm depth for various balloon diameter 5, 6, 8 and 10 mm in diameter respectively. The study was conducted to estimate the absorbed doses to the vessels from various sized large balloons filled with liquid form of Ho-166-DTPA for clinical trial of radiation therapy after the PTA. The absorbed dose distribution of Ho-166 appeared to be nearly ideal for vascular irradiation since beta range is very short avoiding unnecessary radiation to surrounding normal tissues.