Siow Jia Wen, Hoon QiCai Jason, Jenkins Elizabeth, Heblinski Nikola, Makara Mariano
University Veterinary Teaching Hospital, School of Veterinary Science, University of Sydney, Camperdown, NSW, Australia.
JFMS Open Rep. 2020 Oct 21;6(2):2055116920964021. doi: 10.1177/2055116920964021. eCollection 2020 Jul-Dec.
A 3-year-old neutered female domestic shorthair cat presented for a 2-week history of hyporexia, lethargy and weight loss. Aspartate aminotransferase, alanine aminotransferase and cholesterol were mildly elevated. Thoracic radiographs identified a lobulated soft tissue opacity in the caudal thorax to the right of midline, with the border effacing the caudal vena cava and broad-based towards the diaphragm. The broad base was suggestive of diaphragmatic hernia, with the other radiographic features and location suggestive of caval foramen hernia. Ultrasound confirmed diaphragmatic hernia with liver herniation. CT showed the herniation of multiple liver lobes and the gallbladder through a defect at the caval foramen. Herniorrhaphy was performed via ventral midline coeliotomy. Following this procedure, the cat's clinical signs resolved and its weight has been regained.
To our knowledge, this is the first report of successful caval foramen herniorrhaphy in a cat. Caval foramen hernia is a type of congenital diaphragmatic hernia. The authors suggest that its embryopathology involves defective septum transversum development. The case was detected during the standard diagnostic investigation of non-specific clinical signs. Its radiographic findings may easily be mistaken for a pulmonary mass. Although not seen in our case, caval foramen hernia is commonly associated with caudal vena cava obstruction, which can potentially result in Budd-Chiari-like syndrome.
一只3岁已绝育的雌性家养短毛猫因出现两周的食欲减退、嗜睡和体重减轻症状前来就诊。天冬氨酸转氨酶、丙氨酸转氨酶和胆固醇轻度升高。胸部X光片显示在中线右侧的后胸部有一个分叶状软组织密度影，其边界与后腔静脉相融合，基底部宽阔并朝向膈肌。宽阔的基底部提示为膈疝，其他X光表现和位置提示为腔静脉孔疝。超声检查证实为膈疝伴肝脏疝入。CT显示多个肝叶和胆囊通过腔静脉孔处的缺损疝出。通过腹中线剖腹术进行了疝修补术。术后，猫的临床症状消失，体重也已恢复。
据我们所知，这是首例猫腔静脉孔疝修补术成功的报告。腔静脉孔疝是一种先天性膈疝。作者认为其胚胎病理学涉及横隔发育缺陷。该病例是在对非特异性临床症状进行标准诊断检查时发现的。其X光表现可能很容易被误诊为肺部肿块。虽然在我们的病例中未见到，但腔静脉孔疝通常与后腔静脉阻塞有关，这可能会导致类似布加综合征的情况。
