Changes

'''Surgical management''' is usually attempted with congenital cases (after medical management has been attempted) and to treat the underlying cause in acquired cases.

'''Surgical management''' is usually attempted with congenital cases (after medical management has been attempted) and to treat the underlying cause in acquired cases.

*Hernia repair is achieved via a cranial ventral coeliotomy.  The oesophageal hiatus is exposed by transection of left triangular ligament (between the liver and diaphragm) and retraction of the liver.  The phreno-oesophageal ligament is partially incised and the oesophagus is retracted into the abdomen until the lower oesopageal sphincter is identified.  Sutures are then passed to reduce the size of the oesophageal hiatus.  

*'''Hernia repair''' is achieved via a cranial ventral coeliotomy.  The oesophageal hiatus is exposed by transection of left triangular ligament (between the liver and diaphragm) and retraction of the liver.  The phreno-oesophageal ligament is partially incised and the oesophagus is retracted into the abdomen until the lower oesopageal sphincter is identified.  Sutures are then passed to reduce the size of the oesophageal hiatus.  

*An oesophagopexy may also be performed (tacking the oesophagus to the left body wall) or a fundic gastropexy.  A tube gastropexy has the added advantage of allowing cases to be fed if they are suffering from severe oesophagitis or oesophageal ulceration.

*An '''oesophagopexy''' may also be performed (tacking the oesophagus to the left body wall) or a '''fundic gastropexy'''.  A tube gastropexy has the added advantage of allowing cases to be fed if they are suffering from severe oesophagitis or oesophageal ulceration.

*Laryngeal surgery or correction of BOAS if this has contributed to the hernia.

*'''Laryngeal surgery or correction of BOAS''' may be performed if this has contributed to the hernia.

==Prognosis==

==Prognosis==