Peritoneopericardial diaphragmatic hernia in a healthy adult feline (Felis catus domesticus): diagnosis to surgical treatment - Case repor

Ana Carolina de Souza Campos,Caroline Lopes Martini,Fernando Elisio Torres,Viviane Horta Gomes,Lucas Rabaça dos Santos,Gabriela Moscatel Fevrier,Juliana Letícia Rossetto Marques,Stéfani Franco de Sá Menezes

doi:10.29374/2527-2179.bjvm00182

Abstract

Peritoneopericardial diaphragmatic hernia (PPDH) is a communication between the abdomen and the pericardial sac generated by congenital anomalies triggered during diaphragmatic and pericardial development. This report aimed to present the case of an adult, mixed-breed cat, affected by PPDH, focusing on the period from diagnosis to successful surgical correction. The patient had a capricious appetite and weight loss for about four months and started, at the end of this period, a state of apathy. On abdominal ultrasound, the gallbladder (GB) was close to the heart, suggesting diaphragmatic discontinuity. On thoracic radiography, there were changes suggestive of PPDH, pericardial efusion or cardiomegaly with probable dilated cardiomyopathy. Based on these findings, an echocardiogram was performed, highlighting the hepatic lobe and GB internally to the pericardium, causing cardiac compression, although without severe cardiac changes. During surgery, a diaphragmatic defect of 4 cm in diameter was observed with the congested right medial hepatic lobe and hyperemic GB in the pericardial sac. The defect was sutured using the sultan pattern in separate stitches and polyamide threads. The feline returned to feeding with greater interest soon after the surgery, and after 15 days it was fed with dry food and had normal behavior. PPDH can be diagnosed in healthy adult cats, even if there are no apparent respiratory, gastrointestinal, or cardiac signs. The echocardiogram is relevant in the definitive diagnosis, in addition to excluding differential diagnoses, and simple surgical treatment with polyamide thread and sultan suture is successful.

Highlights

Peritoneopericardial diaphragmatic hernia (PPDH) is the most common congenital anomaly of the diaphragm and pericardium in feline species (Johnson, 1993). This is the result of defects during the development of these anatomical structures (Pinto Filho, 2017), generating communication between the abdomen and the pericardial sac (MacPhail, 2014)
Asymptomatic cases are possible when there is no involvement of the herniated viscera (Cunha et al, 2000) and, for this reason, may not be diagnosed for many years (Barrett & Kittrell, 1966; Evans & Biery, 1980)
From the Peritoneopericardial diaphragmatic hernia in a healthy adult feline (Felis catus domesticus): diagnosis to surgical treatment - Case report hernia, using Metzembaum scissors, a 1 cm incision was made in the diaphragm, allowing the mobilization of the contents of the pericardial sac

Summary

Introduction

Peritoneopericardial diaphragmatic hernia (PPDH) is the most common congenital anomaly of the diaphragm and pericardium in feline species (Johnson, 1993). This is the result of defects during the development of these anatomical structures (Pinto Filho, 2017), generating communication between the abdomen and the pericardial sac (MacPhail, 2014). Peritoneopericardial diaphragmatic hernia in a healthy adult feline (Felis catus domesticus): diagnosis to surgical treatment - Case report hernia, using Metzembaum scissors, a 1 cm incision was made in the diaphragm, allowing the mobilization of the contents of the pericardial sac (right medial hepatic lobe and gallbladder). Two months after the surgery, the animal gained weight and already showed normal behavior

Discussion

Conclusion

Ethics statement

Conflict of interests