Campos Ana Carolina de Souza, Dos Santos Lucas Rabaça, Torres Fernando Elisio, Marques Juliana Letícia Rossetto, Martini Caroline Lopes, Menezes Stéfani Franco de Sá, Fevrier Gabriela Moscatel, Gomes Viviane Horta
Veterinarian, Programa de Pós-Graduação em Medicina Veterinária (PPGMV), Departamento de Medicina e Cirurgia Veterinária (DMCV), Instituto de Veterinária (IV) Universidade Federal Rural do Rio de Janeiro (UFRRJ), Campus Seropédica, RJ, Brasil.
Veterinarian, Faculdade de Veterinária (FV), Universidade Federal Fluminense (UFF), Niterói, RJ, Brasil.
Braz J Vet Med. 2021 Mar 23;43:e001820. doi: 10.29374/2527-2179.bjvm001820. eCollection 2021.
Peritoneopericardial diaphragmatic hernia (PPDH) is a communication between the abdomen and the pericardial sac generated by congenital anomalies triggered during diaphragmatic and pericardial development. This report aimed to present the case of an adult, mixed-breed cat, affected by PPDH, focusing on the period from diagnosis to successful surgical correction. The patient had a capricious appetite and weight loss for about four months and started, at the end of this period, a state of apathy. On abdominal ultrasound, the gallbladder (GB) was close to the heart, suggesting diaphragmatic discontinuity. On thoracic radiography, there were changes suggestive of PPDH, pericardial efusion or cardiomegaly with probable dilated cardiomyopathy. Based on these findings, an echocardiogram was performed, highlighting the hepatic lobe and GB internally to the pericardium, causing cardiac compression, although without severe cardiac changes. During surgery, a diaphragmatic defect of 4 cm in diameter was observed with the congested right medial hepatic lobe and hyperemic GB in the pericardial sac. The defect was sutured using the sultan pattern in separate stitches and polyamide threads. The feline returned to feeding with greater interest soon after the surgery, and after 15 days it was fed with dry food and had normal behavior. PPDH can be diagnosed in healthy adult cats, even if there are no apparent respiratory, gastrointestinal, or cardiac signs. The echocardiogram is relevant in the definitive diagnosis, in addition to excluding differential diagnoses, and simple surgical treatment with polyamide thread and sultan suture is successful.
腹膜心包膈疝（PPDH）是在膈肌和心包发育过程中由先天性异常引发的腹腔与心包囊之间的连通。本报告旨在介绍一例患有PPDH的成年混种猫病例，重点关注从诊断到成功手术矫正的这段时间。该患者食欲反复无常且体重减轻约四个月，在此期间结束时开始出现冷漠状态。腹部超声检查显示，胆囊（GB）靠近心脏，提示膈肌连续性中断。胸部X线摄影显示有提示PPDH、心包积液或心脏扩大伴可能的扩张型心肌病的改变。基于这些发现，进行了超声心动图检查，结果显示肝叶和胆囊在心包内部，导致心脏受压，不过尚无严重的心脏变化。手术过程中，观察到一个直径4厘米的膈肌缺损，心包囊内右内侧肝叶充血，胆囊充血。使用苏丹缝合法用单独的缝线和聚酰胺线缝合缺损。这只猫在手术后不久就恢复了更有兴趣的进食，15天后开始喂食干粮，行为正常。即使没有明显的呼吸、胃肠道或心脏症状，PPDH也可在健康成年猫中被诊断出来。超声心动图除了排除鉴别诊断外，对明确诊断也很重要，使用聚酰胺线和苏丹缝合法进行简单的手术治疗是成功的。
