Question of the Day

This necropsy image shows a peritoneopericardial diaphragmatic hernia (PPDH) with the liver in the pericardial sac. In small animals, PPDH is congenital, whereas most diaphragmatic hernias are traumatic.

Clinical signs are often non-specific and depend on which viscera are herniated within the thoracic cavity. Respiratory signs are most common. This may be an incidental finding in up to 50% of cases. Clinical signs of PPDH can be associated with poor venous return to the heart, or respiratory or GI signs.

Dx: Plain or contrast thoracic radiographs, ultrasound. On thoracic radiographs the cardiac silhouette appears significantly enlarged. Click here to see a lateral radiograph of a diaphragmatic hernia in a cat.

Tx: Surgical repair only if the patient is clinical; to alleviate clinical signs, prevent vascular compromise and prevent organ ischemia. If the PPDH is small and incidental or there are no clinical signs, surgical repair may not be indicated.

Image courtesy of Kalumet.