Ribeiro Rafaela Rodrigues, Santos Guilherme Pinheiro, Silva Marco Augusto Machado, Silva Cindy Stefhani Dos Santos, Mendes Tayanne Gobbi, de Moura Rauane Sousa, Oliveira Iago Martins
Escola de Ciências Médicas e da Vida, Pontifícia Universidade Católica de Goiás, Goiânia, Brasil.
Departamento de Medicina Veterinária, Escola de Veterinária e Zootecnia, Universidade Federal de Goiás, Rodovia Goiânia - Nova Veneza, Goiânia, Brasil.
Open Vet J. 2025 May;15(5):2259-2264. doi: 10.5455/OVJ.2025.v15.i5.43. Epub 2025 May 31.
Peritoneopericardial hernias (PPHs) are congenital malformations characterized by continuity defects between the diaphragm and the peritoneum that allow the transposition of abdominal organs into the thoracic cavity. These malformations can lead to clinical, gastroenterological, and respiratory problems, such as vomiting, dyspnea, and tachypnea. They can be congenital, and patients develop clinical signs at a young age or can be diagnosed as incidental when no complications occur. Furthermore, other malformations, such as cryptorchidism and cardiac interventricular communication, can present with congenital HPP.
This article reports a case of PPH in association with a ventricular septal defect (VSD) in a pediatric canine patient. The dog, a female Shih Tzu, aged 2 months, presented with cyanosis, low weight, decreased body condition score (3/9), and underdevelopment in comparison with other puppies of the same litter. At physical examination, all parameters were within the normal range; however, there was a sound at the base of the heart during auscultation, and echocardiographic examination displayed VSD. Due to the dyspnea, thoracic radiography was performed, and the suspicion of PPH was confirmed. Peritoneopericardial hernioplasty surgery was indicated for a 2-month-old patient. During the surgical procedure, it was not necessary to enter the thoracic cavity in order to close the defect, and suture surgery was performed through the abdominal cavity accessed in the subxiphoidal region. Despite the high risks associated with the procedure, no intraoperative or anesthetic complications occurred.
The hernioplasty procedure was considered successful, and the patient's development and body condition score improvement, with the surgical procedure resolving all signs of respiratory distress.
腹膜心包疝（PPH）是一种先天性畸形，其特征是膈肌和腹膜之间存在连续性缺陷，使得腹部器官能够移位至胸腔。这些畸形可导致临床、胃肠和呼吸问题，如呕吐、呼吸困难和呼吸急促。它们可以是先天性的，患者在年轻时出现临床症状，或者在没有并发症发生时被偶然诊断出来。此外，其他畸形，如隐睾症和心脏室间隔交通，也可能与先天性PPH同时出现。
本文报告了一例患有室间隔缺损（VSD）的幼年犬类患者合并PPH的病例。这只狗是一只2个月大的雌性西施犬，与同窝的其他幼犬相比，出现了发绀、体重低、身体状况评分降低（3/9）和发育不良的情况。体格检查时，所有参数均在正常范围内；然而，听诊时心脏底部有杂音，超声心动图检查显示有室间隔缺损。由于呼吸困难，进行了胸部X线摄影，PPH的怀疑得到证实。对于一名2个月大的患者，建议进行腹膜心包疝修补手术。在手术过程中，无需进入胸腔即可闭合缺损，通过剑突下区域进入腹腔进行缝合手术。尽管该手术风险很高，但未发生术中或麻醉并发症。
疝修补手术被认为是成功的，患者的发育和身体状况评分得到改善，手术解决了所有呼吸窘迫的症状。
