Dijagnostika i terapija portosistemskih anastomoza

master's thesis

• Title (english): Diagnosis and Therapy Portosystemic Shunts
• Author: Filip Tkalec
• Mentor: Ivana Kiš (mentor)
• Mentor: Marin Torti (mentor)
• Committee member: Mirna Brkljačić
• Committee member: Marin Torti
• Committee member: Ivana Kiš
• Granter: University of Zagreb; Faculty of Veterinary Medicine; (Surgery, Orthopaedics and Ophtalmology Clinic); Zagreb
• Defense date and country: 2014-11-07, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Veterinary Medicine; Veterinary Clinical Sciences

Abstract

Portosistemske anastomoze (PSA) su nenormalne spojnice kojima se zaobliazi jetra, te
krv iz gastrointestinalnog sustava, direktno ulazi u sustavnu cirkulaciju. Dijele se na urođene i
stečene. Prirođene se dijele na ekstrahepatičke, koje se javljaju kod malih pasmina pasa, i
intrahepatičke, koje se javljaju kod velikih pasmina pasa. Stečeni portosistemski kolateralni
spojevi se pak javljaju kao posljedica portalne hipertenzije. Zbog nakupljanja toksina, koje
jetra ne može u potpunosti detoksicirati, često se javlja jetrena encefalopatija. Dijagnoza se
postavlja na temelju anamneze, kliničkih znakova, laboratorijskih nalaza i ultrazvuka.
Terapija portosistemskih anastomoza podrazumijeva stabilizaciju pacijenata sa jetrenom
encefalopatijom, konzervativno liječenje pacijenata prije operacije ili starijih pacijenata i
pacijenata sa stečenim portosistemskim kolateralama, te također kirurško liječenje
kongenitalnih portosistemskih anastomoza. Poslijeoperacijske komplikacije koje se mogu
javiti su: akutna portalna hipertenzija, tromboza portalne vene, kronična portalna hipertenzija,
epileptoidni napadaji, hemoabdomen i hipoglikemija. Prognoza kod konzervativnog liječenja,
dugoročno je loša dok je kod kirurškog liječenja ovisna o tome o kojoj se vrsti kongenitalne
portosistemske anastomoze radi, da li je prisutna primarna hipoplazija portalne vene, načinu
zatvaranja anastomoze, iskustvu kirurga te samoj starosti životinje kada je bolest
dijagnosticirana.

Abstract (english)

Portosystemic shunts (PSS) are anomalous vessels that allow normal portal blood
draining from the gastrointestinal tract to pass directly into the systemic circulation without
first passing through the liver. Portosystemic shunts can be either congenital or acquired.
Congenital can be extrahepatic, in small breed dogs, and intrahepatic, in large breeds.
Acquired portosystemic shunts (APSS) are usually caused by portal hypertension. Because of
toxin accumulation, which liver can't detoxicate, sings of hepatic encephalopaty ensue. To
make the final diagnosis of PSS we use history, clinical sings, laboratory findings and
ultrasound. Therapy of PSS consists of stabilization of patients with hepatic encephalopathy,
conservative therapy is used of preoperative patients or older patients with APSS, and surgical
therapy of patients with congenital PSS. Postoperative complications are: acute portal
hypertension, portal vein thrombosis, chronic portal hypertension, seizures, hemoabdomen
and hypoglycemia. Prognosis of conservative therapy long—therm is poor, and success of
surgical treatment depends on whether shunt is extrahepatic or intrahepatic, the coexistence of
primary hypoplasia of the portal vein, the extent of shunt attenuation, experience of the
surgeon and the age of the dog at the time of diagnosis.

• Keywords: portosistemske anastomoze
• Keywords (english): portosystemic shunts
• Language: croatian
• URN:NBN: urn:nbn:hr:178:454806
• Study programme: Title: Veterinary Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica veterinarske medicine (doktor/doktorica veterinarske medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Access restricted to students and staff of home institution
• Created on: 2016-01-14 11:16:53