Changes

*'''Para-oesophageal or Rolling hiatal hernia''' - Cranial displacement of the gastric fundus into mediastinum through the oesophageal hiatus but adjacent to the oesophagus and gastric cardia which remain in their normal positions.  This form of hernia is rare in animals.

*'''Para-oesophageal or Rolling hiatal hernia''' - Cranial displacement of the gastric fundus into mediastinum through the oesophageal hiatus but adjacent to the oesophagus and gastric cardia which remain in their normal positions.  This form of hernia is rare in animals.

Acquired hernias can occur in any breed of dog or cat and these often occur with disorders that cause increases in intra-abdominal pressure (such as chronic vomiting) or increases in negative intrathoracic pressure (such as intermittent airway obstruction seen with [[Laryngeal Paralysis - Canine|laryngeal paralysis]] or brachycephalic obstructive airway syndrome (BOAS)).  

Acquired hernias can occur in any breed of dog or cat and these often occur with disorders that cause increases in intra-abdominal pressure (such as chronic vomiting) or decreases in intrathoracic pressure (such as intermittent airway obstruction seen with [[Laryngeal Paralysis - Canine|laryngeal paralysis]] and brachycephalic obstructive airway syndrome (BOAS)).  

==Signalment==

==Signalment==

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

'''Surgical management''' can be used 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 placed 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|oesophagitis]] or oesophageal ulceration.

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

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

[[Category:To_Do_-_James]]

[[Category:To_Do_-_James]]

[[Category:Cat]][[Category:Dog]]

[[Category:Cat]][[Category:Dog]]