ABSTRACT
Abernethy malformation， also known as congenital portosystemic shunts， is rare in clinical practice， with less than 300 cases reported in the global literature up to 2019. The disease can have serious complications such as pulmonary hypertension， liver tumor， and liver failure and tends to have an extremely poor prognosis， and early diagnosis and active and effective treatment can reduce and delay the onset of complications. In this case， portography combined with balloon occlusion helped to display the underdeveloped slender portal vein with dysplasia， so that the child who was formerly misdiagnosed with type Ⅰ Abernethy malformation was diagnosed with type Ⅱ Abernethy malformation， and then the child was successfully treated by transcatheter closure. This article gives a detailed report of this case.
ABSTRACT
BACKGROUND:Pathological change and compression of multiple vertebra often occur following senile osteoporosis,myeloma and metastatic tumor.However,there are few studies concerning treatment of multiple vertebral lesion shaping.OBJECTIVE:To explore therapeutic efficacy,announcements of multiple pathological thorax-lumbar vertebrae treated with once only percutaneous vertebroplasty (PVP).DESIGN,TIME AND SETTING:The observational experiment.Patients were selected from the Department of Spinal Surgery,Department of Rehabilitation,and Department of Tumor,Taihe Hospital from November 2004 to October 2008.PARTICIPANTS:A total of 31 patients from the Department of Spinal Surgery,Department of Rehabilitation,and Department of Tumor,Taihe Hospital with senile osteoporosis combined with compression fracture,general lymphadenomatosis of bones and osteolytic metastatic tumor,14 males,17 females,with an age of 56-82 years old.METHODS:Thirty-one cases of multiple pathological thorax-lumbar vertebrae were treated with PVP.Following local anesthesia,affected vertebral body underwent vertebrae root puncturation.Under strict monitoring,bone cement was injected into the vertebral body in order.Following surgery,vertebral body condition and patients' reaction were observed.Therapeutic efficacy was evaluated 1 week following surgery.MAIN OUTCOME MEASURES:The following parameters were measured:centrum puncture success ratio,disposable centrum forming number,bone cement injection quantity,centrum bone cement distribution situation,leakage of bone cement to soft tissue and vein surrounding the vertebra,ache alleviation,and complications.RESULTS:A total of 75 vertebroplasy was used 33 times,2 vertebral bodies at least once only,and 5 vertebral bodies at most once only,with an average of 2.27 vertebral bodies once only.4-12 mL of bone cement was injected in each vertebral body,averagely 7.5 mL.Uniformity injection was done in 49 cases,and partial injection in 26 cases.Without serious complications,all the patients relieved in local pain parts following surgery.Significant remission or disappearance was determined in 20 cases,and partial remission in 11 cases.CONCLUSION:PVP is a safe and effective method in treatment of multiple pathological thorax-lumbar vertebrae.The key of operation is reasonable injection and thorough monitoring.