Pleuroperitoneal true diaphragmatic hernia of the liver in a cat

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

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