Todayโs path rounds are on ๐๐ข๐๐ฉ๐ก๐ซ๐๐ ๐ฆ๐๐ญ๐ข๐ ๐ก๐๐ซ๐ง๐ข๐๐ฌ!
๐๐ก๐๐ญ ๐ข๐ฌ ๐ข๐ญ?
๐๐๐ซ๐ง๐ข๐๐ฌ in general are when the intestine becomes displaced through a hole itโs not supposed to go through. These can occur in many different locations! Today weโre going to talk about ๐๐ข๐๐ฉ๐ก๐ซ๐๐ ๐ฆ๐๐ญ๐ข๐ ๐ก๐๐ซ๐ง๐ข๐๐ฌ specifically, which is where the intestines become displaced through a hole in the diaphragm.
๐๐ก๐จ ๐ ๐๐ญ๐ฌ ๐ข๐ญ?
Any species can get this!
๐๐ก๐๐ญ ๐๐๐ฎ๐ฌ๐๐ฌ ๐ข๐ญ?
Pretty much anything that can cause a hole in the diaphragm to form can lead to a diaphragmatic hernia. In some cases, the animal may have been born with a hole in the diaphragm due to improper development.
However, the most common cause is trauma, like being hit by a car. This sudden impact increases the pressure in the abdominal cavity, leading to tearing of the diaphragm to try and alleviate the pressure. This pressure then causes the intestines to push through the hole into the chest!
๐๐ก๐ฒ ๐ข๐ฌ ๐ญ๐ก๐ข๐ฌ ๐ ๐ฉ๐ซ๐จ๐๐ฅ๐๐ฆ?
Surprisingly, many animals can live with diaphragmatic hernias with minimal symptoms! As long as the intestine is able to move freely within the hole, and doesnโt become twisted or compromise other organs, owners may not know their animal has a diaphragmatic hernia.
These hernias can begin to cause issues if they become ๐ข๐ง๐๐๐ซ๐๐๐ซ๐๐ญ๐๐, meaning that the intestine is no longer able to move freely and becomes stuck in the chest. This is typically caused by formation of scar tissue around the diaphragm hole, which contracts down and makes the hole too small for free movement of intestine. This can interfere with normal movement of gut contents, causing accumulation of fluid in the portion of the intestine in the chest. This predisposes it to ๐ฏ๐จ๐ฅ๐ฏ๐ฎ๐ฅ๐ฎ๐ฌ (twisting, cutting off blood flow) or even rupture.
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐๐ข๐๐ ๐ง๐จ๐ฌ๐๐?
Typically these are diagnosed on either an X-ray or an ultrasound, however the veterinarian may have an initial suspicion if they hear gut sounds when they try to listen to the lungs!
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐ญ๐ซ๐๐๐ญ๐๐?
These lesions have to be treated surgically. In this surgery, the abdomen is opened and the intestines are pulled back through the hole in the diaphragm, then the hole is closed to prevent a repeat hernia. Animals tend to do fairly well after surgical repair, assuming they werenโt having major issues before they went for surgery.
๐๐ก๐จ๐ญ๐จ๐ฌ
1-5) Diaphragmatic hernias with varying stages of badness. To help orient yourself, remember that the liver (big brown thing) sits right along the abdomen side of the diaphragm. Any intestines on the other side of the liver are in the wrong place!
6) An example of a hole in the diaphragm that let intestines slide through.
๐๐จ๐ฎ๐ซ๐๐๐ฌ
Maxie, G. Jubb, Kennedy and Palmerโs Pathology of Domestic Animals, Volume 2. Sixth Edition.
Photos 1-3, 6 courtesy of University of Calgary Diagnostic Services Unit.
Photos 4-5 courtesy of Noahโs Arkive.
