Hiatal herniation as a complication of chronic diaphragmatic herniation.

Three of four cases of chronic diaphragmatic herniation seen over a period of 12 months developed hiatal herniation within five to eight days of corrective surgery for the diaphragmatic herniation. None of the dogs had shown any prior signs referrable to hiatal herniation. The features that developed subsequent to diaphragmatic herniorrhaphy in all cases were dyspnoea, increased intra-abdominal pressure due to decreased abdominal domain and laxity of the oesophageal hiatus as judged subjectively at the time of surgery for hiatal herniation correction. These conditions may be significant underlying factors for the development of hiatal herniation not preceded by diaphragmatic herniation in the dog. Those associated factors accepted as important in humans, including reduced lower oesophageal sphincter tone and gastro-oesophageal reflux, may not be of similar importance in small animals.