Hernia, Peritoneopericardial Diaphragmatic

Common pericardial congenital defect in dogs & cats

Description

Pericardio-Peritoneo-Diaphragmatic Hernia (PPDH) is a congenital abnormality characterized by the incomplete formation of the diaphragm. The incomplete formation allows for a section of the diaphragm to remain patent allowing abdominal contents (e.g. intestines, liver) to move into the thoracic cavity and eventually into the pericardial sac.

Diagnosis

History & Clinical Signs

-Asymptomatic

-Vomiting

-Diarrhea

-Abdominal Pain

-Anorexia

-Weight Loss

-Shock

Physical Exam

-Empty Abdomen on palpation

-Quiet Heart Sounds

-Gut sounds around the heart (If gut is herniated)

Radiography

-Enlarged cardiac silhouette

-Intestines in the pericardial sac (seen best with barium swallow)

Echocardiography

-Abdominal organs in the pericardial sac

Treatment

-Surgical closure of the defect

Prognosis

-Good with surgery

Peritoneopericardial diaphragmatic hernia

See Hernia

• More commonly seen possibly due to longer survival
• Sometimes associated with cardiac abnormalities, malformations of sternum, costochondral junctions or umbilical hernia
• Sometimes present with respiratory difficulty, failure to thrive, vomiting

Represents an embryological malformation of the ventral midline with communication to varying degress of the pericardial sac and the peritoneal cavity. Often associated with other malformations for example sternal deformities and ventricular septal defects. Usually results in gastrointestinal or respiratory signs. Visible radiologically as a round cardiac silhouette which merges with the diaphragm. The trachea will be displaced dorsally. Intestines may be visible on radiographs. Repaired surgically.