IMAGING DIAGNOSIS—POSITIVE CONTRAST PERITONEOGRAPHIC FEATURES OF TRUE DIAPHRAGMATIC HERNIA

A true diaphragmatic hernia is a congenital diaphragmatic malformation that can appear identical to a peritoneopericardial diaphragmatic hernia (PPDH). True diaphragmatic hernias are rare in dogs. Herein we describe the use of positive contrast peritoneography for diagnosis of a true diaphragmatic hernia in two dogs.     

Congenital pleuroperitoneal hernia presenting as gastrothorax in five cavalier King Charles spaniel dogs

Five cavalier King Charles spaniels were examined for acute onset of respiratory distress. Thoracic radiographs demonstrated diaphragmatic hernia and tension gastrothorax, visible as a distended stomach occupying the left caudal thoracic cavity. Exploratory midline coeliotomy confirmed congenital pleuroperitoneal diaphragmatic hernia with herniation and dilatation of the stomach. The hernia configuration was consistent in all cases, with a defect affecting the left diaphragmatic crus. Congenital pleuroperitoneal diaphragmatic hernia is a rare condition caused by a defect in the dorsolateral diaphragm. Defects of the left crus of the diaphragm could result in the herniation of the stomach into the thoracic cavity with possible subsequent tension gastrothorax. Cavalier King Charles spaniels may have a predisposition to this condition. Tension gastrothorax is an acute life‐threatening consequence of gastric herniation through a diaphragmatic defect that must be promptly recognised and surgically treated.     

A fatal case of complicated congenital peritoneopericardial diaphragmatic hernia in a Holstein calf

Congenital peritoneopericardial diaphragmatic hernia is a rare condition most commonly reported in cats and dogs. A 6-week-old Holstein heifer calf with a congenital peritoneopericardial diaphragmatic hernia complicated by a perforated abomasal ulcer is described. The clinical signs and pathological findings are compared with those reported in other species.     

创伤性膈疝修复术

本病例通过对创伤性膈疝实施手术修复,并对膈疝成因及手术成功的因素做了总结,对于该类手术的实施及预后,有了进一步的经验积累。     

Diaphragmatic Hernia Repair in Three Young Horses

Objective- This clinical report describes surgical correction of diaphragmatic hernia in three young horses.
Study Design- Retrospective investigation of medical records and subsequent racing performance.
Animals- Three young horses with diaphragmatic hernia.
Results- Three young horses with signs of abdominal pain had diaphragmatic hernia causing small intestinal strangulation. The strangulated small intestine was resected and an end-to-end jejuno-jejunal (two horses) or a side-to-side jejuno-cecal anastomosis (one horse) was performed. Diaphragmatic hernias were closed with a continuous suture pattern. All horses recovered and raced. No difference in race records was found between the subject horses and their siblings. One subject horse died of colic at 5 years of age, but the cause of the colic was undetermined. The remaining two horses are in use as broodmares and have produced multiple foals without recurrence of signs of diaphragmatic hernia
Conclusions- Diaphragmatic hernias can be repaired in horses. These horses can achieve race records similar to their siblings and can produce foals without recurrence of signs of diaphragmatic hernia.     

Diaphragmatic herniation as a cause of lethargy and exercise intolerance in a mare.

A diaphragmatic hernia in which 90% of the large colon had herniated through a 16-cm linear tear in the diaphragm was found in a 12-year-old Quarter Horse mare. Clinical signs included lethargy and exercise intolerance. Diagnosis of diaphragmatic hernia was made based on careful thoracic auscultation, combined with ultrasonographic and radiographic examination of the thorax.     

Perioperative survival rates after surgery for diaphragmatic hernia in dogs and cats: 92 cases (1990-2002)

OBJECTIVE: To determine the survival rates of dogs and cats that underwent surgical treatment for traumatic diaphragmatic hernia within 24 hours of admission and determine whether timing of surgery affected perioperative survival rate. DESIGN: Retrospective study. ANIMALS: 63 dogs and 29 cats treated surgically for traumatic diaphragmatic hernia. PROCEDURE: Medical records were reviewed to evaluate associations between perioperative survival rates and variables including timing of surgery in relation to admission and acute versus chronic diaphragmatic hernia. RESULTS: Among the 92 animals, 82 (89.1%) were discharged alive after surgery. Sixty-four (69.6%) patients received surgical intervention within 12 hours of admission, and 84 (91.3%) received surgical intervention within 24 hours of admission. Median time from admission to discharge was 4 days (2 to 33 days). Data for acute cases (68 dogs and cats) were analyzed separately. Sixty-three (92.6%) patients with acute diaphragmatic hernia received surgical intervention within 24 hours of admission to the hospital, and 59 (93.7%) of these patients were discharged alive. Twenty-nine (42.6%) patients with acute diaphragmatic hernia received surgical intervention within 24 hours of trauma, and 26 of 29 (89.7%) patients were discharged alive. An overall acute and chronic perioperative survival rate of 89.7% was observed in dogs and cats that received surgical intervention within 24 hours of admission. CONCLUSIONS AND CLINICAL RELEVANCE: Results in 68 dogs and cats that underwent surgery within 24 hours of admission suggested that early surgical intervention for acute diaphragmatic hernia was associated with good perioperative survival rates.     

Bochdalek Congenital Diaphragmatic Hernia in an Adult Sheep

Congenital diaphragmatic hernia (CDH) is a rare condition. The aetiology of CDH is often unclear. In our case, a hollow mass was noted on MRI. Cardiac ejection fraction was diminished (47.0%) compared to 60.5% (average of 10 other normal animals, P < 0.05). The final diagnosis of congenital diaphragmatic hernia (Bochdalek type) was made when the sheep underwent surgery. The hernia was right‐sided and contained the abomasum. Lung biopsy demonstrated incomplete development with a low number of bronchopulmonary segments and vessels. The likely cause of this hernia was genetic malformation.     

Pneumopericardium after peritoneopericardial diaphragmatic hernia repair in a dog

A one-year-old neutered, Goldendoodle presented for evaluation. One week prior to presentation, the surgical closure of a peritoneopericardial diaphragmatic hernia was performed via ventral midline celiotomy. Since the procedure, the dog had been lethargic and anorexic at home. Thoracic radiographs revealed a pneumopericardium. Pericardiocentesis was performed which evacuated approximately 100 mL of air from the pericardial sac. The dog recovered well and began eating in the hospital and resumed normal activity. This is the first reported case of a pneumopericardium post-peritoneopericardial diaphragmatic hernia repair requiring pericardiocentesis. Clinicians should be aware of this rare complication in patients with post-operative peritoneopericardial diaphragmatic hernia.     

An unusual cause of colic in a neonatal foal

A case of a neonatal foal with acute colic and respiratory distress is described. The foal presented with signs of acute colic and was treated medically. The foal did not respond to treatment and 2 h after admission the foal began to demonstrate signs of respiratory distress. Thoracic and abdominal radiographs were obtained and a diagnosis of a diaphragmatic hernia was made. Surgical repair of the hernia was recommended but the owner declined and the foal was subjected to euthanasia. Post mortem findings confirmed the diagnosis and revealed that the defect was of congenital origin. Congenital diaphragmatic hernia is an unusual cause of colic in a neonatal foal.     

Thoracoscopic-assisted diaphragmatic hernia repair using a thoracic rib resection

OBJECTIVE: To describe the surgical treatment of a dorsal diaphragmatic hernia in an adult horse using thoracic rib resection aided by thoracoscopy and a flank incision. STUDY DESIGN: Case report. ANIMAL POPULATION: One client-owned horse. RESULTS: A six-year-old Dutch warmblood gelding was admitted for colic-associated colonic incarceration in a diaphragmatic hernia. Seven weeks after the initial colic surgery, the gelding underwent surgery to repair the defect. Thoracoscopy and a flank incision were used to identify the location of the hernia and the subsequent site of rib resection. The stomach was adhered to the edges of the defect, leaving only a small residual hole. Resection of the 14th rib provided excellent exposure of the defect and closure of the remaining hernia. CONCLUSION AND CLINICAL RELEVANCE: Thoracic rib resection can provide access to diaphragmatic hernias in adult horses. Thoracoscopy or a flank incision, or both, may aid in determining which rib is best resected.     

Lung lobe torsion in association with a chronic diaphragmatic hernia and haemorrhagic pleural effusion in a cat

CLINICAL SUMMARY: This report describes torsion of the right cranial lung lobe in a cat with haemorrhagic pleural effusion and a chronic diaphragmatic hernia. Surgical treatment comprising lung lobectomy without de-rotation, and repair of the diaphragmatic defect, led to an uneventful recovery. PRACTICAL RELEVANCE: Lung lobe torsion is a rare condition in cats. While spontaneous lung lobe torsions may occur, a frequent association with underlying thoracic disease has been recognised in cats. However, neither haemorrhagic pleural effusion nor diaphragmatic hernia have been previously described in cats with lung lobe torsions, although they have been documented in dogs and humans. In a cat with suspected lung lobe torsion, a thorough search for an underlying disease should be undertaken.     

Surgical Repair of a Diaphragmatic Tear in a Thoroughbred Broodmare

A 9-year-old multiparous Thoroughbred broodmare presented for evaluation of acute signs of colic. The patient had a 4-month history of poor appetite, weight loss, and decreased body condition after parturition, despite appropriate feeding by the farm to minimize weight loss associated with increased nutrient requirements. The patient was diagnosed with a diaphragmatic hernia through transabdominal and thoracic ultrasonography. The diaphragmatic hernia was repaired surgically under general anesthesia.     

Diaphragmatic and perineal hernias associated with cutaneous asthenia in a cat

An 11-year-old cat was evaluated because of dyspnea. Since 11 months of age, the cat had hyperextensibility of the skin consistent with cutaneous asthenia. Radiographic examination revealed a diaphragmatic hernia with intestinal loops in the thorax. Electron microscopic examination of skin specimens revealed collagen fibers of highly variable diameter, consistent with cutaneous asthenia. The diaphragmatic hernia was surgically repaired and healed well. Four weeks later, a left-sided perineal hernia was repaired surgically, and 4 months later, a right-sided perineal hernia was repaired surgically and colopexy and cystopexy were performed. All surgical procedures were successful and tissues healed well. Dermatosparaxis is a rare hereditary disorder that commonly results in cutaneous fragility and hyperextensibility in affected animals. The diagnosis depends on clinical findings and light and electron microscopic changes in affected tissues. Surgical repair can be performed successfully in an affected cat, and healing of incisions can occur without complications.     

Marked pleural effusion causing right atrial collapse simulating cardiac tamponade in a dog

A 16-month-old, female German shepherd dog was presented with severe bicavitary effusions. A diaphragmatic hernia was diagnosed by thoracic radiography. An echocardiogram performed prior to surgical repair of the hernia revealed signs of cardiac tamponade, with right atrial collapse, in the absence of pericardial effusion. Right atrial collapse was presumed to be secondary to severe pleural effusion. At surgery, no pericardial disease was identified. Surgical correction of the diaphragmatic hernia resulted in resolution of the pleural and peritoneal effusions. Follow-up echocardiography demonstrated resolution of the signs of cardiac tamponade.     

Gastric dilatation-volvulus associated with diaphragmatic hernia in three cats: clinical presentation, surgical treatment and presumptive aetiology

Three cats were examined because of acute dyspnoea and sudden abdominal enlargement. In all cats, radiographs revealed gastric dilatation-volvulus (GDV) and diaphragmatic hernia. Cardiovascular shock and dyspnoea were treated by intravenous fluid-therapy, oxygen administration and relief of diaphragmatic pressure by means of stomach decompression and in one case placing the patient in an inclined position. Gastric decompression was performed by needle gastrocentesis, placement of a rhino-gastric tube, or a combination of these. Diaphragmatic herniorrhaphy was performed in either case; one cat also underwent gastropexy. The immediate postoperative period resolved uneventfully and the cats were doing well at follow-up. Feline GDV is a rare event in which diaphragmatic hernia may be a predisposing factor.     

Surgical correction of a diaphragmatic hernia in a newborn calf

A 2-day-old Holstein calf was admitted to the Veterinary Teaching Hospital (VTH) in St-Hyacinthe for respiratory distress. Thoracic auscultations revealed asymmetric lung sounds. A diaphragmatic hernia was diagnosed on thoracic radiographs. Herniorrhaphy was performed; postoperative recovery was uneventful. This case indicates that diaphragmatic hernia in calves can be surgically treated successfully.     

Mummified Fetus in the Thoracic Cavity of a Domestic Short-haired Cat

This short communication describes the diagnosis, treatment, and clinical course of a domestic short-haired cat with diaphragmatic hernia in which the herniated structure in the thoracic cavity contained a mummified fetus. The cat was pregnant when rescued from the street and, days later, gave birth without abnormalities. Some months later, during an ovariohysterectomy, an abnormal localization of the uterus was observed, and at that time the case was referred to our center. A thoracic radiograph showed an abnormal thoracic mass cranial to the heart. The main suspicion was the presence of a thoracic hernia with the uterus herniated and containing a mummified fetus. A thoracotomy was performed to confirm the nature of the mass and reduce the diaphragmatic hernia. Although this clinical case is quite rare, a mummified fetus can be observed in thoracic hernias.     

Clinical, echocardiographic, and radiographic findings of peritoneopericardial diaphragmatic hernia in two dogs and a cat

Peritoneopericardial diaphragmatic hernia was diagnosed in 2 dogs and a cat. One dog was referred because of clinical signs of cardiac tamponade and acute decompensation from liver entrapment within the hernia. Surgical correction of the hernia alleviated clinical signs in all 3 animals. Echocardiography was used in combination with radiography to provide a rapid and accurate diagnosis.     

2002: Hiatal hernia in a puppy

A sliding hiatal hernia (where the terminal oesophagus, oesophagogastric junction and part of the stomach move cranially through a diaphragmatic defect) was diagnosed in a 4-month-old, Shar-Pei puppy presented for evaluation of regurgitation. The diagnosis was confirmed using radiography. Herniorraphy consisted of repositioning the stomach within the abdomen, plicating the diaphragmatic hiatus and performing a tube gastropexy to the left abdominal wall. Veterinary practitioners should have a high index of suspicion of hiatal hernia in young puppies, particularly Shar-Peis and British Bull Dogs, that present with persistent vomiting or regurgitation.