Peritoneopericardial diaphragmatic hernia with a small intestinal obstruction within the pericardial sac
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A two year old male, castrated English Bulldog, was presented to Cornell University Hospital for Animal’s Emergency Service for lethargy, vomiting, inappetance, and diarrhea in May of 2010. On presentation, the dog was quiet, alert, and responsive. His heart sounds were mildly muffled but there were no murmurs or arrhythmias noted. Decreased lung sounds were noted on auscultation, particularly on the right. Intestinal loops could not be abdominally palpated, and his abdomen appeared grossly small. Based on orthogonal thoracic radiographs, a diagnosis of a Peritoneopericardial Diaphragmatic Hernia (PPDH) was made. The presenting clinical signs and diagnosis of a PPDH warranted surgery. This case was found to be unique and complicated at surgery because not only did the pericardial sac contain an entire length of jejunum and a small portion of the quadrate lobe of the liver, but there was also a foreign body in the ileum within the pericardial space. The patient handled the surgery well and recovered successfully.
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Seminar SF610.1 2011