Derré Maxime G, Findji Laurent, McLauchlan Gerard, Guilherme Sérgio
Fitzpatrick Referrals Oncology and Soft Tissue Hospital, Guildford, UK.
Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, IN, USA.
JFMS Open Rep. 2022 May 7;8(1):20551169221090449. doi: 10.1177/20551169221090449. eCollection 2022 Jan-Jun.
A 7-month-old intact female Maine Coon presented with a 2-week history of vomiting. A peritoneopericardial diaphragmatic hernia (PPDH) and a mass arising from the cardia, protruding into the gastric lumen, were diagnosed using a combination of ultrasound and CT. An exploratory gastrotomy revealed a circumferential, irregular, ulcerated mass involving the submucosal layer of the cardia. This mass was excised by partial-thickness resection of the gastro-oesophageal wall. The PPDH was corrected and a gastrostomy feeding tube was placed under the same anaesthetic. Histopathologically, the most characteristic feature of this mass was a submucosal fibroplasia associated with marked ulceration and granulation tissue. No infectious or neoplastic cells were identified. The affected region of the gastric wall appeared narrowly excised. Resolution of clinical signs was achieved until the cat was lost to follow-up 12 months postoperatively.
This is the first report of the surgical management of an oesophagogastric mass in a cat with a concurrent PPDH and no other underlying disease. A benign fibrous mass should be considered as a differential diagnosis of an oesophagogastric mass in feline patients with PPDH. While medical and surgical options are debated for the management of PPDH, symptomatic patients with a concurrent oesophagogastric mass are legitimate candidates for surgical herniorrhaphy to prevent further complications. Based on this case, prognosis can be considered good if surgical resection is complete.
一只7个月大未绝育的雌性缅因猫出现了为期2周的呕吐症状。通过超声和CT联合检查，诊断出该猫患有腹膜心包膈疝（PPDH）以及一个源于贲门、突入胃腔的肿物。剖腹探查术显示，一个环绕性、不规则、溃疡型肿物累及贲门黏膜下层。通过胃食管壁的部分厚度切除，切除了该肿物。在同一次麻醉下，修复了PPDH并放置了胃造口喂养管。组织病理学检查显示，该肿物最典型的特征是黏膜下纤维增生，伴有明显溃疡和肉芽组织。未发现感染或肿瘤细胞。胃壁的病变区域似乎切除范围较窄。术后12个月，在猫咪失访前，临床症状得到缓解。
这是首例关于一只患有PPDH且无其他基础疾病的猫的食管胃肿物手术治疗的报告。对于患有PPDH的猫科动物患者，良性纤维性肿物应被视为食管胃肿物的鉴别诊断之一。虽然对于PPDH的治疗在药物和手术选择上存在争议，但对于同时患有食管胃肿物的有症状患者，手术修补疝是预防进一步并发症的合理选择。基于该病例，如果手术切除彻底，可认为预后良好。
