Page 311 - Feline diagnostic imaging

19.3 ­eritoneopericardial Diaphragmatic ernia ­­D H 317

(a) (b)

(c)

Figure 19.3 Lateral (a), ventrodorsal (b), and transverse computed tomographic images (c) for a cat presenting for thoracic mass
found as an incidental finding by the referring veterinarian. A fat opacity mass was identified on thoracic radiographic images
although best seen on the ventrodorsal image. The mass is silhouetting with the ventral diaphragm on the lateral view. On the
computed tomographic image, this fat opacity mass is identified in the caudoventral thoracic cavity. The diaphragm appears
incomplete ventrally at the level of the fatty mass consistent with a diaphragmatic hernia. Source: Images courtesy of Dr Merrilee
Holland, Auburn University.

19.3 Peritoneopericardial cranially into the pericardial sac. The liver appears to be
Diaphragmatic Hernia (PPDH) the most commonly herniated organ, followed by gallblad-
der, small intestines, omentum, stomach, colon, falciform
Peritoneopericardial diaphragmatic hernia is a congenital ligament, and spleen [9]. Clinical signs are variable, with
(not traumatic) defect resulting in persistent communica- this defect often noted on thoracic images as an incidental
tion (congenital hiatus) between the pericardial sac and finding unrelated to the primary patient complaint. Clinical
diaphragm [6–9]. It is thought to be due to a failure of nor- signs attributed to the PPDH are generally respiratory and
mal development of the septum transversus (which forms gastrointestinal in nature, and include dyspnea, tachypnea,
the ventral portion of the diaphragm). Domestic longhair coughing, intermittent anorexia, diarrhea, and vomiting
and Himalayan species may be overrepresented [9]. [9]. One cat died as a result of cardiac tamponade second-
Variable amounts of abdominal viscera are displaced ary to PPDH [9].