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Tierarztl Prax Ausg K Kleintiere Heimtiere 2020; 48(04): 292-296
DOI: 10.1055/a-1200-4080
Case Report

Pleuroperitoneal true diaphragmatic hernia of the liver in a cat

Echte pleuroperitoneale Zwerchfellhernie der Leber bei einer Katze
Mehmet Pilli
1   Department of Surgery, Faculty of Veterinary Medicine, Near East University Nicosia, TRNC
,
Fatma E. Özgencil
1   Department of Surgery, Faculty of Veterinary Medicine, Near East University Nicosia, TRNC
,
Deniz Seyrek-Intas
1   Department of Surgery, Faculty of Veterinary Medicine, Near East University Nicosia, TRNC
,
Cagri Gültekin
1   Department of Surgery, Faculty of Veterinary Medicine, Near East University Nicosia, TRNC
,
Kürsad Turgut
2   Department of Internal Medicine, Faculty of Veterinary Medicine, Near East University Nicosia, TRNC
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Abstract

A 2-year old female domestic shorthair cat was referred with intermittent vomiting. Laboratory analyses revealed only an elevated alanine aminotransferase activity. Plain thoracic radiographs showed a right-sided transdiaphragm protrusion of a liver lobe into the thoracic cavity. On abdominal ultrasound the diaphragm and liver parenchyma also presented a bulge towards the thoracic cavity. By cranial median laparotomy herniation of the quadrate liver lobe through the right aspect of the diaphragm into the thoracic cavity was confirmed. The protruding quadrate liver lobe was covered by intact parietal peritoneum. Following relocation of the liver lobe the defect was closed. Postoperatively the intermittent vomiting stopped. The purpose of this case report was to present plain radiography and abdominal ultrasonography as effective tools in the diagnosis of this rare and usually asymptomatic true herniation case along with its operative treatment.

Zusammenfassung

Eine 2-jährige einheimische Kurzhaarkatze wurde aufgrund von intermittierendem Erbrechen vorgestellt. Labordiagnostisch ergab sich bei dem klinisch unauffälligen Tier nur eine erhöhte Alanin-Aminotransferase-Aktivität. Auf nativen Röntgenaufnahmen des Thorax zeigte sich eine rechtsseitige Zwerchfellhernie der Leber. Sonografisch ließ sich ein bogenförmiger Vorfall eines Leberanteils in Richtung Thorax darstellen. Die kraniale mediane Laparotomie bestätigte, dass rechtsseitig ein Teil des Lobus quadratus der Leber umhüllt mit parietalem Bauchfell durch eine Öffnung im Zwerchfell in die Brusthöhle verlagert war. Nach Rückverlagerung des Leberanteils wurde der Defekt verschlossen. Postoperativ sistierte die klinische Symptomatik. Das Ziel des Fallberichts ist, den seltenen und normalerweise asymptomatischen Fall einer echten Zwerchfellhernie mit der operativen Behandlung vorzustellen und zu zeigen, dass native Röntgen- und abdominale Ultraschalluntersuchungen effektive Verfahren zur Diagnosestellung sind.

Key words

Cat - true diaphragmatic hernia - pleuroperitoneal hernia - ALT

Schlüsselwörter

Katze - echte diaphragmatische Hernie - pleuroperitoneale Hernie - ALT


Publication History

Received: 04 October 2019

Accepted: 04 May 2020

Article published online:
21 August 2020

© Georg Thieme Verlag KG
Stuttgart · New York

 

  • References

  • 1 Bierman MI. Diaphragmatic hernia, non-traumatic. Radiology 1924; 3 (03) 233-239 doi:10.1148/3.3.233
    CrossrefPubMedGoogle Scholar
  • 2 Voges AK, Bertrand S, Hill RC. et al. True diaphragmatic hernia in a cat. Vet Radiol Ultrasound 1997; 38 (02) 116-119 DOI: 10.1111/j.1740–8261.1997.tb00825.x.
    CrossrefPubMedGoogle Scholar
  • 3 Suter PF. Abnormalities of the diaphragm. In: Suter PF, Lord PF. eds. Thoracic radiography: A text Atlas of Thoracic Disease of the Dog and Cat. Wettswil, Switzerland: Suter; 1984: 179-204
    Google Scholar
  • 4 McGeady TA, Quinn PJ, FitzPatrick ES. et al. Coelomic Cavities. In: McGeady TA, Quinn PJ, FitzPatrick ES. et al., eds. Veterinary Embryology. Oxford, UK: Blackwell; 2006: 59-65
    Google Scholar
  • 5 Burrow R, Davidson J. Congenital hernia. https://www.vetstream.com/treat/felis/diseases/congenital-hernia 2019 Accessed: 10.07.2019
    PubMedGoogle Scholar
  • 6 Smith SA, Goggin JM, Kraft SL. What is your diagnosis? A 2-cm Rounded Structure Similar in Opacity to Adjacent Falciform Fat Located Between the Apex of the Heart and the Cupula of the Diaphragm Along the Ventral Midline of the Thorax. J Am Vet Med Assoc 1999; 214 (04) 479-480
    PubMedGoogle Scholar
  • 7 Green EM, Thamm DH. What is your diagnosis? A soft-tissue mass in the thoracic cavity between the heart and the right crus of the diaphragm. J Am Vet Med Assoc 2000; 216 (01) 23-24 doi:10.2460/javma.2000.216.23
    CrossrefPubMedGoogle Scholar
  • 8 Cariou MP, Shihab N, Kenny P. et al. Surgical management of an incidentally diagnosed true pleuroperitoneal hernia in a cat. J Feline Med Surg 2009; 11 (10) 873-837 DOI: 10.1016/j.jfms.2009.04.001.
    CrossrefPubMedGoogle Scholar
  • 9 Keep JM. Congenital diaphragmatic hernia in a cat. Aust Vet J 1950; 26: 193-196 doi:10.1111/j.1751–0813.1950.tb04936.x
    CrossrefPubMedGoogle Scholar
  • 10 Mann FA, Aronson E, Keller G. Surgical correction of a true congential pleuroperitoneal diaphragmatic hernia in a cat. J Am Anim Hosp Assoc 1991; 27: 501-507
    PubMedGoogle Scholar
  • 11 Parry A. Positive contrast peritoneography in the diagnosis of a pleuroperitoneal diaphragmatic hernia in a cat. J Feline Med Surg 2010; 12 (02) 141-143 doi:10.1016/j.jfms.2009.06.002
    CrossrefPubMedGoogle Scholar
  • 12 Rose AM, Ryan SD, Johnstone T. et al. Imaging diagnosis – the Computed Tomography Features of a Pleuroperitoneal Hernia in a cat. Vet Radiol Ultrasound 2017; 58 (05) 55-59 DOI: 10.1111/vru.12406.
    CrossrefPubMedGoogle Scholar
  • 13 White JD, Tisdall PLC, Norris JM. et al. Diaphragmatic hernia in a cat mimicking a pulmonary mass. J Feline Med Surg 2003; 5: 197-201 DOI: 10.1016/S1098–612X(02)00069–4.
    CrossrefPubMedGoogle Scholar
  • 14 Kozat S, Sepehrizadeh E. Methods of Diagnosing in Liver Diseases for Dog and Cats. Turkish J Scient Rev 2017; 10 (02) 36-46
    PubMedGoogle Scholar
  • 15 Richter KP. Hepatobiliary/pancreatic diseases. In: Côté E. ed. Clinical Veterinary Advisor: Dogs and Cats. 3 rd ed.. St. Louis, USA: Mosby, Elsevier; 2015: 193-195
    Google Scholar
  • 16 Gomez S, Bexfield N, Scase T. et al. Total serum bilirubin as a negative prognostic factor in idiopathic canine chronic hepatitis. J Vet Diagn Invest 2014; 26 (02) 246-251 DOI: 10.1177/1040638713520602.
    CrossrefPubMedGoogle Scholar
  • 17 Gaumnitz J. Canine liver enzymes – so many questions. http://veterinarymedicine.dvm360.com/canine-liver-enzymes-so-many-questions Accessed: 30.07.2019
    PubMedGoogle Scholar
  • 18 Watson PJ. Hepatobiliary Diseases in the Cat. In: Nelson RW, Couto CG. eds. Small Animal Internal Medicine. 5th ed.. St. Louis, USA: Mosby, Elsevier; 2014: 536-558
    Google Scholar