Todayโs path rounds are on ๐ฉ๐๐ซ๐ข๐ญ๐จ๐ง๐๐จ๐ฉ๐๐ซ๐ข๐๐๐ซ๐๐ข๐๐ฅ ๐๐ข๐๐ฉ๐ก๐ซ๐๐ ๐ฆ๐๐ญ๐ข๐ ๐ก๐๐ซ๐ง๐ข๐๐ฌ!
๐๐ก๐ฒ ๐๐จ๐๐ฌ ๐ฏ๐๐ญ ๐ฆ๐๐ ๐ก๐๐ฏ๐ ๐ฌ๐ฎ๐๐ก ๐ซ๐ข๐๐ข๐๐ฎ๐ฅ๐จ๐ฎ๐ฌ๐ฅ๐ฒ ๐ฅ๐จ๐ง๐ ๐ฐ๐จ๐ซ๐๐ฌ? ๐๐ก๐๐ญ ๐ญ๐ก๐ ๐ก๐๐๐ค ๐ข๐ฌ ๐ญ๐ก๐๐ญ?
Letโs break it down into the key parts! ๐๐๐ซ๐ข๐ญ๐จ๐ง๐๐จ- refers to the peritoneum, which is the membrane that lines the abdomen. ๐๐๐ซ๐ข๐๐๐ซ๐๐ข๐๐ฅ refers to the pericardium, the membrane sac that covers the heart. ๐๐ข๐๐ฉ๐ก๐ซ๐๐ ๐ฆ๐๐ญ๐ข๐ ๐ก๐๐ซ๐ง๐ข๐๐ฌ are when some part of the intestinal tract or abdominal organs ๐ก๐๐ซ๐ง๐ข๐๐ญ๐๐ฌ (protrudes) through the ๐๐ข๐๐ฉ๐ก๐ซ๐๐ ๐ฆ, the muscular border between the abdomen and thorax that aids in breathing. So putting it all together, we have a hernia of abdominal organs through the diaphragm, due to a connection between the peritoneum and pericardium. Weird!
๐๐ก๐จ ๐ ๐๐ญ๐ฌ ๐ข๐ญ?
Any species can get this! For some reason though, it is most commonly seen in cats.
๐๐ก๐๐ญ ๐๐๐ฎ๐ฌ๐๐ฌ ๐ข๐ญ?
This is usually a ๐๐จ๐ง๐ ๐๐ง๐ข๐ญ๐๐ฅ problem, meaning the animal had this issue from birth due to a developmental issue. It is not certain what the underlying causes are, but it is likely that something causing damage to the developing diaphragm is what leads to this hernia.
๐๐ก๐ฒ ๐ข๐ฌ ๐ญ๐ก๐ข๐ฌ ๐ ๐ฉ๐ซ๐จ๐๐ฅ๐๐ฆ?
This may seem obvious, but your abdominal organs are not supposed to be in your thorax! This type of hernia in particular is extra bad, because not only are the abdominal organs in the thorax, theyโre contained within the pericardium surrounding the heart. Because the pericardium can only stretch a little bit, all these extra organs put pressure on the heart, preventing its normal functions, which can lead to collapse and death. Additionally, the abdominal organs donโt like being in the thorax either, so they can be compromised as well, depending on how twisted around they get when they pass through the diaphragm.
That said, some animals live happy, long lives without their owners ever knowing they have this condition! If the heart is able to beat properly, and thereโs enough blood flow to the herniated organs to allow them to function, this condition may be an ๐ข๐ง๐๐ข๐๐๐ง๐ญ๐๐ฅ ๐๐ข๐ง๐๐ข๐ง๐ (something we found while looking for something else) during a surgery, or if the animal receives X-rays for another reason.
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐๐ข๐๐ ๐ง๐จ๐ฌ๐๐?
Because these are so rare, they definitely arenโt at the top of a veterinarianโs ๐๐ข๐๐๐๐ซ๐๐ง๐ญ๐ข๐๐ฅ ๐ฅ๐ข๐ฌ๐ญ (possible causes for symptoms) when they have animals presenting with abdominal organ issues. Usually, as part of an abdominal investigation, X-rays or ultrasound would be completed, and would reveal this issue!
๐๐จ๐ฐ ๐ข๐ฌ ๐ข๐ญ ๐ญ๐ซ๐๐๐ญ๐๐?
These are treated surgically, with the surgeon pulling all the abdominal organs out of the pericardial sac, replacing them in the abdomen, and then closing the hole they herniated through.
๐๐ก๐จ๐ญ๐จ๐ฌ
1) An X-ray showing this type of hernia. There are quite a few things that can cause the ๐๐๐ซ๐๐ข๐๐ ๐ฌ๐ข๐ฅ๐ก๐จ๐ฎ๐๐ญ๐ญ๐ (the outline of the heart) to be enlarged like you see in this X-ray, however there arenโt very many that lead to the liver not showing up!
2) A normal X-ray for comparison.
3-4) Photos taken at necropsy showing liver herniation into the pericardial sac.
๐๐จ๐ฎ๐ซ๐๐๐ฌ
Maxie, G. Jubb, Kennedy and Palmerโs Pathology of Domestic Animals, Volume 2. Sixth Edition.
Zwingenberger, A. 11 year old DMH cat. Veterinary Radiology blog May 25th, 2017.
Photo 1 courtesy of A. Zwingenberger.
Photo 2 courtesy of University of Illinois.
Photo 3 courtesy of University of Calgary Diagnostic Services Unit.
Photo 4 courtesy of Noahโs Arkive.
