Hérnia diafragmática peritôniopericárdica congênita em uma gata / Congenital peritoniopericardial diaphragmatic hernia in a female kitten

Background: Peritoneopericardial diaphragmatic hernia is a rare pathogenesis of congenital origin, which occurs due to a failure in the communication between the diaphragm and the pericardium during embryogenesis. Symptoms may be non-existent or non-specific, depending on the herniated organ involved and, in most cases, the diagnosis is incidental. Regarding the most indicated treatment, there are still divergences in the literature concerning the indication of conservative or surgical treatment. This study reports the case of a feline peritoneopericardial hernia, for which surgical correction was the treatment of choice. Case: A 3-month-old female kitten, no defined racial pattern, was referred to the Veterinary Hospital of the Federal Rural University of Pernambuco for treatment of a peritoneopericardial diaphragmatic hernia. This condition was diagnosed through radiographic examination after the patient having been submitted to pediatric castration and presented anesthetic complications in the transsurgery. Blood count, biochemical profile and Doppler echocardiogram were performed, which showed no significant changes. To obtain a better study and surgical planning, computed tomography was performed to observe the heart located cranially in the pericardial cavity. Caudally to the heart, hepatic parenchyma located in the pericardial cavity was observed; and hepatic vessels presenting slightly enlarged dimensions. These tomographic findings suggested peritoneopericardial diaphragmatic hernia; being the liver present in the pericardial cavity and signs of congestion in the hepatic parenchyma. Due to the likelihood of future worsening of the hernia, surgical correction was performed, with an abdominal midline incision in the preumbilical region to reposition the liver to its normal anatomy, followed by diaphragm reconstitution through a herniorrhaphy. After the surgical procedure, the patient was referred for observation in internment and, after 15 days, the skin sutures were removed. Complete correction of the hernial defect was observed on radiography performed 30 days after the surgical procedure. However, the examination showed the presence of deviation/ deformity in the topography of the sternum and costal cartilages, with slight cardiac displacement to the right hemithorax, suggesting the presence of pectus excavatum. Discussion: Peritoneopericardial diaphragmatic hernia is considered rare and, despite being one of the most common causes of congenital pericardial anomaly in felines, it has a low prevalence ranging from 0.06% to 1.45%. They are usually diagnosed from two years of age, with prevalence for older animals. However, due to having presented anesthetic changes, the patient of this case report could be diagnosed early. Among the most common organs that migrate to the thoracic cavity, the liver is the most commonly observed, which is also the hernia content of the present report. Peritoneopericardial hernia is often diagnosed through radiography and ultrasound, and these imaging tests proved to be sufficient for the diagnosis in this report. However, computed tomography was important for providing a better study of case and for the adoption of median celiotomy as a treatment. Associations with other malformations are described in the literature, with pectus excavatum being the most common and also observed in this report. Peritoneopericardial diaphragmatic hernia is a rare anomaly, rarely reported in the literature and with divergences regarding its treatment. The adoption of early surgical treatment performed in this report showed satisfactory evolution and the possibility of a favorable prognosis.

Clinical, surgical, and radiographic aspects in a white-eared opossum (Didelphis albiventris) with traumatic diaphragmatic hernia / Aspectos clínicos, cirúrgicos e radiográficos em um Gambá-de-orelha-branca (Didelphis albiventris) com hérnia diafragmática traumática

This is the case of a specimen of Didelphis albiventris with signs of respiratory difficulty after a dog attack. Thoracic radiographic examination revealed pneumothorax, pulmonary contusion, and rib fracture, but no alteration compatible with diaphragmatic hernia was observed. Pneumothorax was reduced and the other alterations were treated. However, clinical manifestations persisted, and thus a contrast-gastrointestinal radiographic study was performed, showing abdominal organs in the thoracic cavity and loss of diaphragmatic line. The surgical approach was instituted, with access to the diaphragm through median laparotomy. Through the diaphragmatic rupture, present in the left antimere, there were herniated liver and gastric portions, intestinal segments, and omentum. After inspection and repositioning of the abdominal organs, the diaphragm raffia was performed with single sutures interrupted with 3-0 Nylon thread. The patient’s complete recovery occurred 14 days after the surgical procedure, with remission of clinical manifestations and normality of thoracic images in radiographic studies.

Esse é o caso de um espécime de Didelphis albiventris com sinais de dificuldade respiratória após ataque por cão. O exame radiográfico torácico revelou pneumotórax, contusão pulmonar e fratura de costelas, porém nenhuma alteração com-patível com hérnia diafragmática foi observada. O pneumotórax foi reduzido e as demais alterações tratadas. Contudo; houve a persistência das manifestações clínicas, e dessa forma um estudo radiográfico gastrointestinal contrastado foi realizado, sendo evidenciados órgãos abdominais na cavidade torácica e perda da linha diafragmática. A abordagem cirúrgica foi instituída, com acesso ao diafragma por meio de laparotomia mediana. Através da ruptura diafragmática, presente no antímero esquerdo, estavam herniadas porções hepáticas e gástricas, segmentos intestinais e omento. Após inspeção e reposicionamento dos órgãos abdominais, a rafia do diafragma foi realizada com suturas simples interrompidas com fio Nylon 3-0. A recuperação completa do paciente ocorreu 14 dias após o procedimento cirúrgico, com remissão das manifestações clínicas e normalidade das ima-gens torácicas nos estudos radiográficos.

Clinical, surgical, and radiographic aspects in a white-eared opossum (Didelphis albiventris) with traumatic diaphragmatic hernia / Aspectos clínicos, cirúrgicos e radiográficos em um Gambá-de-orelha-branca (Didelphis albiventris) com hérnia diafragmática traumática

This is the case of a specimen of Didelphis albiventris with signs of respiratory difficulty after a dog attack. Thoracic radiographic examination revealed pneumothorax, pulmonary contusion, and rib fracture, but no alteration compatible with diaphragmatic hernia was observed. Pneumothorax was reduced and the other alterations were treated. However, clinical manifestations persisted, and thus a contrast-gastrointestinal radiographic study was performed, showing abdominal organs in the thoracic cavity and loss of diaphragmatic line. The surgical approach was instituted, with access to the diaphragm through median laparotomy. Through the diaphragmatic rupture, present in the left antimere, there were herniated liver and gastric portions, intestinal segments, and omentum. After inspection and repositioning of the abdominal organs, the diaphragm raffia was performed with single sutures interrupted with 3-0 Nylon thread. The patients complete recovery occurred 14 days after the surgical procedure, with remission of clinical manifestations and normality of thoracic images in radiographic studies.(AU)

Esse é o caso de um espécime de Didelphis albiventris com sinais de dificuldade respiratória após ataque por cão. O exame radiográfico torácico revelou pneumotórax, contusão pulmonar e fratura de costelas, porém nenhuma alteração com-patível com hérnia diafragmática foi observada. O pneumotórax foi reduzido e as demais alterações tratadas. Contudo; houve a persistência das manifestações clínicas, e dessa forma um estudo radiográfico gastrointestinal contrastado foi realizado, sendo evidenciados órgãos abdominais na cavidade torácica e perda da linha diafragmática. A abordagem cirúrgica foi instituída, com acesso ao diafragma por meio de laparotomia mediana. Através da ruptura diafragmática, presente no antímero esquerdo, estavam herniadas porções hepáticas e gástricas, segmentos intestinais e omento. Após inspeção e reposicionamento dos órgãos abdominais, a rafia do diafragma foi realizada com suturas simples interrompidas com fio Nylon 3-0. A recuperação completa do paciente ocorreu 14 dias após o procedimento cirúrgico, com remissão das manifestações clínicas e normalidade das ima-gens torácicas nos estudos radiográficos.(AU)

Diaphragmatic hernia and unilateral renal agenesis in a crab-eating fox (Cerdocyon thous)

An approximately 3-month-old crab-eating fox (Cerdocyon thous) was found by environmental authorities in the State of Paraiba, Northeastern Brazil and referred to a wildlife care center. The fox was presenting respiratory distress and it was referred to the Veterinary Hospital of the Federal University of Paraiba (UFPB) for ancillary testing. Abdominal and thoracic ultrasound and radiographies were performed. These imaging tests indicated the fox had a possible diaphragmatic hernia and ectopic kidney. The imageology results were confirmed on necropsy, which revealed a postero-lateral focal discontinuity of the dorsal aspect of the diaphragmatic muscle with protrusion of the gastrointestinal tract into the thoracic cavity. The stomach and intestinal loops were filled with gas and obliterated the visualization of the heart and lungs. Additionally, only the right kidney was found, and no vestigial left kidney was identified. Congenital diaphragmatic hernias are not commonly observed in wildlife but should be considered as a potential differential diagnosis for acute onset of respiratory distress in young carnivores.(AU)

Diaphragmatic hernia and unilateral renal agenesis in a crab-eating fox (Cerdocyon thous)

An approximately 3-month-old crab-eating fox (Cerdocyon thous) was found by environmental authorities in the State of Paraiba, Northeastern Brazil and referred to a wildlife care center. The fox was presenting respiratory distress and it was referred to the Veterinary Hospital of the Federal University of Paraiba (UFPB) for ancillary testing. Abdominal and thoracic ultrasound and radiographies were performed. These imaging tests indicated the fox had a possible diaphragmatic hernia and ectopic kidney. The imageology results were confirmed on necropsy, which revealed a postero-lateral focal discontinuity of the dorsal aspect of the diaphragmatic muscle with protrusion of the gastrointestinal tract into the thoracic cavity. The stomach and intestinal loops were filled with gas and obliterated the visualization of the heart and lungs. Additionally, only the right kidney was found, and no vestigial left kidney was identified. Congenital diaphragmatic hernias are not commonly observed in wildlife but should be considered as a potential differential diagnosis for acute onset of respiratory distress in young carnivores.

Ultrasound diagnosis of reticular diaphragmatic hernia in bovines

ABSTRACT: A reticular diaphragmatic hernia is a congenital or acquired alteration resulting from protrusion of the reticulum into the thoracic cavity. In ruminants, lesions to the diaphragmatic muscle, due to penetration of sharp metallic objects, is the most common cause of this disease. Therefore, given the low number of reports on this disease in the bovine species, the current study aims to describe the clinical, laboratory, and anatomopathological findings, with special emphasis on the ultrasound diagnosis of five cattle with reticular diaphragmatic hernia. The laboratory data were analyzed using mean and standard deviation, and clinical, ultrasound, and pathological findings were evaluated using descriptive statistics. Clinically the animals exhibited varying degrees of dehydration, abdominal distension, tympany, and alterations in ruminal motility, in addition to cardiorespiratory alterations such as murmur, dyspnea, and muffling of lung sounds. The laboratory examination showed neutrophilic leukocytosis and hyperfibrinogenemia. The ultrasonographic images demonstrated reticulum inside the thoracic cavity adjacent to the lung and heart, although no reticular motility was observed. The pathological lesions confirmed the findings of the ultrasound exams. Thus, the current study demonstrated that ultrasonography was efficient in diagnosing reticular diaphragmatic hernia in the bovine species.

RESUMO: A hérnia reticular diafragmática é uma alteração congênita ou adquirida resultante da protrusão do retículo para o interior da cavidade torácica. Em ruminantes, lesões no músculo diafragmático devido a penetração de objetos metálico pontiagudos constitui a causa mais comum dessa enfermidade. Portanto, diante dos poucos relatos a cerca dessa enfermidade nos animais da espécie bovina, este estudo tem como objetivo descrever os achados clínicos, laboratoriais, anatomopatológicos e dar ênfase especial no diagnóstico ultrassonográfico de cinco bovinos acometidos com hérnia reticular diafragmática. Os dados laboratoriais foram analisados utilizando-se media e desvio padrão e os achados dos exames clínico, ultrassonográfico e anatomopatológicos foram avaliados através de estatística descritiva. Clinicamente os animais exibiam desidratação em variados graus, distensão abdominal, timpania e alterações na motilidade ruminal. Além de alterações cardiorrespiratórias como sopro, dispneia e abafamento dos sons pulmonares. O exame laboratorial revelou leucocitose por neutrofilia e hiperfibrinogenemia. As imagens ultrassonográficas revelaram retículo no interior da cavidade torácica adjacente ao pulmão e coração, porém nenhuma motilidade reticular foi observada. As lesões anatomopatológicas confirmaram os achados dos exames ultrassonográficos. Dessa maneira, este trabalho demonstrou que a ultrassonografia foi eficiente no diagnóstico da hérnia reticular diafragmática nos animais da espécie bovina.

Ultrasound diagnosis of reticular diaphragmatic hernia in bovines / Diagnóstico ultrassonográfico da hérnia reticular diafragmática em bovinos

A reticular diaphragmatic hernia is a congenital or acquired alteration resulting from protrusion of the reticulum into the thoracic cavity. In ruminants, lesions to the diaphragmatic muscle, due to penetration of sharp metallic objects, is the most common cause of this disease. Therefore, given the low number of reports on this disease in the bovine species, the current study aims to describe the clinical, laboratory, and anatomopathological findings, with special emphasis on the ultrasound diagnosis of five cattle with reticular diaphragmatic hernia. The laboratory data were analyzed using mean and standard deviation, and clinical, ultrasound, and pathological findings were evaluated using descriptive statistics. Clinically the animals exhibited varying degrees of dehydration, abdominal distension, tympany, and alterations in ruminal motility, in addition to cardiorespiratory alterations such as murmur, dyspnea, and muffling of lung sounds. The laboratory examination showed neutrophilic leukocytosis and hyperfibrinogenemia. The ultrasonographic images demonstrated reticulum inside the thoracic cavity adjacent to the lung and heart, although no reticular motility was observed. The pathological lesions confirmed the findings of the ultrasound exams. Thus, the current study demonstrated that ultrasonography was efficient in diagnosing reticular diaphragmatic hernia in the bovine species.(AU)

A hérnia reticular diafragmática é uma alteração congênita ou adquirida resultante da protrusão do retículo para o interior da cavidade torácica. Em ruminantes, lesões no músculo diafragmático devido a penetração de objetos metálico pontiagudos constitui a causa mais comum dessa enfermidade. Portanto, diante dos poucos relatos a cerca dessa enfermidade nos animais da espécie bovina, este estudo tem como objetivo descrever os achados clínicos, laboratoriais, anatomopatológicos e dar ênfase especial no diagnóstico ultrassonográfico de cinco bovinos acometidos com hérnia reticular diafragmática. Os dados laboratoriais foram analisados utilizando-se media e desvio padrão e os achados dos exames clínico, ultrassonográfico e anatomopatológicos foram avaliados através de estatística descritiva. Clinicamente os animais exibiam desidratação em variados graus, distensão abdominal, timpania e alterações na motilidade ruminal. Além de alterações cardiorrespiratórias como sopro, dispneia e abafamento dos sons pulmonares. O exame laboratorial revelou leucocitose por neutrofilia e hiperfibrinogenemia. As imagens ultrassonográficas revelaram retículo no interior da cavidade torácica adjacente ao pulmão e coração, porém nenhuma motilidade reticular foi observada. As lesões anatomopatológicas confirmaram os achados dos exames ultrassonográficos. Dessa maneira, este trabalho demonstrou que a ultrassonografia foi eficiente no diagnóstico da hérnia reticular diafragmática nos animais da espécie bovina.(AU)

Ultrasound diagnosis of reticular diaphragmatic hernia in bovines / Diagnóstico ultrassonográfico da hérnia reticular diafragmática em bovinos

A reticular diaphragmatic hernia is a congenital or acquired alteration resulting from protrusion of the reticulum into the thoracic cavity. In ruminants, lesions to the diaphragmatic muscle, due to penetration of sharp metallic objects, is the most common cause of this disease. Therefore, given the low number of reports on this disease in the bovine species, the current study aims to describe the clinical, laboratory, and anatomopathological findings, with special emphasis on the ultrasound diagnosis of five cattle with reticular diaphragmatic hernia. The laboratory data were analyzed using mean and standard deviation, and clinical, ultrasound, and pathological findings were evaluated using descriptive statistics. Clinically the animals exhibited varying degrees of dehydration, abdominal distension, tympany, and alterations in ruminal motility, in addition to cardiorespiratory alterations such as murmur, dyspnea, and muffling of lung sounds. The laboratory examination showed neutrophilic leukocytosis and hyperfibrinogenemia. The ultrasonographic images demonstrated reticulum inside the thoracic cavity adjacent to the lung and heart, although no reticular motility was observed. The pathological lesions confirmed the findings of the ultrasound exams. Thus, the current study demonstrated that ultrasonography was efficient in diagnosing reticular diaphragmatic hernia in the bovine species.(AU)

A hérnia reticular diafragmática é uma alteração congênita ou adquirida resultante da protrusão do retículo para o interior da cavidade torácica. Em ruminantes, lesões no músculo diafragmático devido a penetração de objetos metálico pontiagudos constitui a causa mais comum dessa enfermidade. Portanto, diante dos poucos relatos a cerca dessa enfermidade nos animais da espécie bovina, este estudo tem como objetivo descrever os achados clínicos, laboratoriais, anatomopatológicos e dar ênfase especial no diagnóstico ultrassonográfico de cinco bovinos acometidos com hérnia reticular diafragmática. Os dados laboratoriais foram analisados utilizando-se media e desvio padrão e os achados dos exames clínico, ultrassonográfico e anatomopatológicos foram avaliados através de estatística descritiva. Clinicamente os animais exibiam desidratação em variados graus, distensão abdominal, timpania e alterações na motilidade ruminal. Além de alterações cardiorrespiratórias como sopro, dispneia e abafamento dos sons pulmonares. O exame laboratorial revelou leucocitose por neutrofilia e hiperfibrinogenemia. As imagens ultrassonográficas revelaram retículo no interior da cavidade torácica adjacente ao pulmão e coração, porém nenhuma motilidade reticular foi observada. As lesões anatomopatológicas confirmaram os achados dos exames ultrassonográficos. Dessa maneira, este trabalho demonstrou que a ultrassonografia foi eficiente no diagnóstico da hérnia reticular diafragmática nos animais da espécie bovina.(AU)

Hérnia diafragmática peritoneopericárdica em um felino da raça Persa / Peritoneopericardial diaphragmatic hernia in a Persian cat

Background: Peritoneopericardial diaphragmatic hernia is a congenital defect characterized by an anomalous communication between the abdominal cavity and pericardial sac, which can lead to displacement of the abdominal viscera into the thoracic cavity. The occurrence in felines is higher among long-haired breeds, mainly the Persian breed, possibly based onan autosomal recessive inheritance. The diagnosis of PPDH is performed by means of chest radiography with or without contrast, in association with other imaging tests such as ultrasonography and echocardiography. Our objective in this study was to report the occurrence and macroscopic changes in a case of peritoneopericardial diaphragmatic hernia in a Persian feline. Case: A 9-year-old male Persian cat weighing 3.4 kg was referred to the HPET-Private Veterinary Clinic, Salvador, Bahia, with an history of weight loss and chronic intermittent vomiting during the preceding 6 months, with lateral decubitus and breathing difficulties. Ultrasonography revealed findings suggestive of an infiltrative process in the stomach and duodenum, enlarged gastric lymph nodes, and some nodular images indicating slight displacement of the liver. Chest radiography revealed a cardiac silhouette with markedly enlarged dimensions associated with a dorsal deviation of the terminal trachea, and echocardiography revealed a small amount of pericardial effusion. The patient showed initial clinical improvement after blood transfusion; however, after 2 days, he exhibited significant clinical worsening and was therefore euthanized with the owner's consent. Post mortem evaluation revealed partial herniation of the liver and gallbladder into the chest cavity through a diaphragmatic hernia ring. The heart was partially surrounded by the left medial lobe of the liver, which was displaced into the pericardial sac. Herniated hepatic lobes had an irregular capsular surface with evident lobulation and tension lipidosis. In the abdominal cavity, the remainder of the liver (right lateral and medial lobes) was observed to be slightly enlarged, with an irregular surface, diffusely reddish with intense evidence of the lobular pattern and white and firm multifocal areas (fibrosis). In the duodenum, close to the pylorus, there was a nodule measuring 2.8 x 2.5 x 1.0 cm, with a whitish and ulcerated surface. When cut, it was soft and exhibited a homogeneous, whitish compact surface. Histopathological examinationshowed marked proliferation of fibrous connective tissue, which for the most part separated the lobes by septa and surrounded the portal space (fibrosis), a marked diffuse chronic inflammatory infiltrate composed of lymphocytes and plasma cells. In addition, marked bile duct hyperplasia and multifocal areas of fatty degeneration (steatosis). Discussion: The diagnosis was based on the association of clinical and pathological findings. Considering the age and clinical signs presented by the patient in this report, as well as the presence of few radiographic signs that were indicative of PPDH, the first differential diagnosis thought was pericardial neoplasia. Peritoneopericardial diaphragmatic hernia in felines is always of congenital origin and may occur asymptomatically depending on the number and involvement of herniated viscera. In this case, the patient's diagnosis of peritoneopericardial hernia was a necropsy finding; the fact that in agreement with previous reports of high rates of incidental diagnoses reinforces the importance of performing necropsy for confirmation or diagnosis of unexpected pathologies. In the present case, peritoneopericardial diaphragmatic hernia in isolation may not have led to severe anemia that culminated in the patient's death. The anatomopathological findings were compatible with biliary cirrhosis and multifocal liver fibrosis, accompanied by the presence of anemia and consequent hypovolemia.

Diagnosis and treatment of a peritoneopericardial hernia in an adult dog: a case report / Diagnóstico e tratamento de hérnia peritoniopericárdica em cão adulto: relato de caso

Peritoneopericardial diaphragmatic hernia is a common congenital pericardial anomaly in dogs and cats, characterized by a communication between the abdomen and the pericardial sac. Animals may be asymptomatic or show nonspecific clinical signs related to the gastrointestinal and cardiorespiratory systems. In this report, we present a case of a 3-year-old female Schnauzer, weighing 7,7 kg, with a history of easy fatigue and cyanosis triggered by stress. The diagnosis of peritoneopericardial diaphragmatic hernia was confirmed through echocardiography and simple and contrast radiography findings that showed the presence of hepatic lobes in the pericardial sac. The animal underwent supra-umbilical celiotomy to correct the hernia and subsequently presented immediate improvement of clinical signs.

A hérnia diafragmática peritoniopericárdica é uma anomalia congênita pericárdica comum em cães e gatos, sendo caracterizada pela comunicação entre abdômen e saco pericárdico. Os animais podem ser assintomáticos ou apresentar sinais clínicos inespecíficos relacionados aos sistemas gastrointestinal e cardiorrespiratório. Expõe-se um caso de um cão Schnauzer, fêmea, 3 anos de idade, pesando 7,7 kg, com histórico de cansaço fácil e cianose em momentos de estresse. O diagnóstico de hérnia peritoniopericárdica foi confirmado por meio de ecocardiografia e exame radiográfico simples e contrastado que evidenciaram a presença de lobos hepáticos no saco pericárdico. O animal foi submetido a celiotomia pré-umbilical para correção do defeito, apresentando melhora imediata dos sinais clínicos após a correção cirúrgica.

Diagnosis and treatment of a peritoneopericardial hernia in an adult dog: a case report / Diagnóstico e tratamento de hérnia peritoniopericárdica em cão adulto: relato de caso

Peritoneopericardial diaphragmatic hernia is a common congenital pericardial anomaly in dogs and cats, characterized by a communication between the abdomen and the pericardial sac. Animals may be asymptomatic or show nonspecific clinical signs related to the gastrointestinal and cardiorespiratory systems. In this report, we present a case of a 3-year-old female Schnauzer, weighing 7,7 kg, with a history of easy fatigue and cyanosis triggered by stress. The diagnosis of peritoneopericardial diaphragmatic hernia was confirmed through echocardiography and simple and contrast radiography findings that showed the presence of hepatic lobes in the pericardial sac. The animal underwent supra-umbilical celiotomy to correct the hernia and subsequently presented immediate improvement of clinical signs.(AU)

A hérnia diafragmática peritoniopericárdica é uma anomalia congênita pericárdica comum em cães e gatos, sendo caracterizada pela comunicação entre abdômen e saco pericárdico. Os animais podem ser assintomáticos ou apresentar sinais clínicos inespecíficos relacionados aos sistemas gastrointestinal e cardiorrespiratório. Expõe-se um caso de um cão Schnauzer, fêmea, 3 anos de idade, pesando 7,7 kg, com histórico de cansaço fácil e cianose em momentos de estresse. O diagnóstico de hérnia peritoniopericárdica foi confirmado por meio de ecocardiografia e exame radiográfico simples e contrastado que evidenciaram a presença de lobos hepáticos no saco pericárdico. O animal foi submetido a celiotomia pré-umbilical para correção do defeito, apresentando melhora imediata dos sinais clínicos após a correção cirúrgica.(AU)

Epidemiological and pathological aspects of noninfectious diseases of the gastrointestinal tract in 114 horses in Southern Brazil / Aspectos epidemiológicos e patológicos de doenças não infecciosas do trato gastrointestinal de 114 equinos no sul do Brasil

Equine colic is one of the most common cause of death in horses, but few studies have investigated specifically the conditions at the necropsy. This study aimed to describe the epidemiological and pathological features of noninfectious diseases of the gastrointestinal tract in horses. A retrospective study was conducted in search of cases of these diseases affecting horses from 2005 to 2017. During this period, 114 horses died of noninfectious diseases of the gastrointestinal tract, and the main causes were: primary gastric dilation (27/114), volvulus (27/114), enterolithiasis (20/114), rectal (colonic) perforation (15/114), gastric or cecocolonic impaction (10/114), incarcerations (6/114), intussusception (4/114), and others (5/114). Mixed breeds horses (56/114) and males (69/114) were mostly affected. The horses had a median and mean age of 10 and 10.9-years old, respectively. Primary gastric dilation was characterized by distension of the stomach by moderate to large amounts of content, which in 21 cases caused tearing of the stomach wall at the greater curvature (peritonitis), and the main predisposing factor was alimentary overload (17/27). Intestinal volvulus occurred within the small intestine (14 cases) and within the large intestines (13 cases). Grossly, there was intestinal ischemia with reddened to deep-black serosa and diffusely red mucosae. Enterolithiasis caused partial or complete obstruction of the right dorsal colon (9/20), transverse colon (4/20), small colon and right dorsal colon (3/20), rectum and right dorsal colon (2/20), and small colon (2/20). Viscera perforation and peritonitis occurred in 11 cases. Rectal (colonic) perforation involved the rectum (10/15), rectum/small colon (4/15), and the small colon (1/15). It was characterized by a focally extensive transmural tearing, associated with reddened borders, and retroperitoneal to diffuse peritonitis. Palpation related iatrogenic injuries (11/15) were the main cause. Impactions affected the large colon (7/10), the cecum (2/10), and the stomach (1/10). Incarcerations consisted of inguinoscrotal hernias (2/6), small intestine entrapment by a mesenteric failure (2/6), diaphragmatic hernia, and umbilical eventration. Grossly, the organs were constricted by a hernial ring, with intestinal ischemia and reddened to dark-red serosa. Predisposing factors included previous surgeries (2/6) and patent inguinal ring (1/6). Intussusception involved the small intestine (3/4) and ileocecum (1/4). Foals with lack of colostrum intake and concomitant pneumonia was a characteristic presentation (3/4). Grossly, the intussusceptum slipped into intussuscipiens, with diffuse deep black-red discoloration. Other causes included large colon displacement (2/5), extrinsic and intrinsic obstruction of the small intestine (2/5), and an intestinal adenocarcinoma. Noninfectious gastrointestinal diseases are major causes of death in horses. Epidemiological and gross features of the conditions should be accounted to obtain a final diagnosis of the cause of the colic.(AU)

A cólica em equinos é considerada como a principal causa de morte de cavalos, porém poucos estudos têm investigado especificamente as condições envolvidas através da necropsia. O objetivo desse estudo foi descrever os aspectos epidemiológicos e patológicos de doenças não infecciosas do trato gastrointestinal de equinos. Foi conduzido um estudo retrospectivo em busca de casos dessas doenças envolvendo cavalos de 2005 a 2017. Durante esse período, 114 equinos morreram devido a doenças não infecciosas do trato gastrointestinal, e as principais causas foram: dilatação gástrica (27/114), vólvulos (27/114), enterolitíase (20/114), ruptura retal (colônica) (15/114), compactação gástrica ou cecocolônica (10/114), encarceramentos (6/114), intussuscepções (4/114), e outros (5/114). Animais sem raça definida (56/114) e machos (69/114) foram mais afetados. Os equinos apresentavam uma média e mediana de idade de 10 e 10,9 anos, respectivamente. A dilatação gástrica primária era caracterizada por distensão do estômago por moderada a grande quantidade de conteúdo, que em 21 casos provocava ruptura da parede gástrica na curvatura maior (peritonite), e o principal fator predisponente foi sobrecarga alimentar (17/27). Vólvulo intestinal ocorreu no intestino delgado e no intestino grosso (14 e 13 casos, respectivamente). Macroscopicamente, havia isquemia intestinal com serosa avermelhada a enegrecida e mucosa difusamente avermelhada. A enterolitíase causou obstrução parcial ou completa do cólon dorsal direito (9/20), cólon transverso (4/20), cólon menor e cólon dorsal direito (3/20), cólon menor (2/20), e reto e cólon maior direito (2/20). Perfuração de vísceras e peritonite foram observadas em 11 casos. A ruptura retal (colônica) envolveu o reto (10/15), reto/cólon menor (4/15) e cólon menor (1/15). Essa era caracterizada por ruptura transmural focalmente extensa, com bordos avermelhados e peritonite retroperitoneal a difusa. Traumas relacionados à palpação (11/15) foram a principal causa. Compactações afetaram o cólon maior (7/10), ceco (2/10) e estômago (1/10). Encarceramentos consistiram em hérnias inguinoescrotais (2/6), encarceramento de alças intestinais por falha no mesentério (2/6), hérnia diafragmática e eventração umbilical. Macroscopicamente, os órgãos estavam constritos por um anel hernial, com isquemia intestinal e serosa avermelhada a vermelho-escura. Fatores predisponentes incluíram cirurgias prévias (2/6) e anel inguinal patente (1/6). Intussuscepções envolveram o intestino delgado (3/4) e íleoceco (1/4). A apresentação característica foi em potros com falta de colostro e concomitante pneumonia. Macroscopicamente, o intussuscepto deslizava em direção ao intussuscepiente, exibindo coloração vermelho-enegrecida difusa. Outras causas incluíram deslocamento de cólon maior (2/5), obstrução extrínseca e intrínseca do intestino delgado (2/5), e um caso de adenocarcinoma intestinal. Doenças não infecciosas são importantes causas de morte em equinos. Os aspectos epidemiológicos e macroscópicos das condições devem ser considerados para o que o diagnóstico final da causa da cólica seja obtido.(AU)

Acquired diaphragmatic eventration in a dog

Background: Diaphragmatic eventration is characterized by weakness of the diaphragmatic muscle, which leads to cranialdislocation of the affected diaphragm and, ultimately, in dyspnea. This condition is rare in humans and even rarer in animals,and may be congenital or acquired. The acquired form is less commom and may be induced by trauma or inflammationand neoplastic invasion of the phrenic nerve. Here, we report a case of acquired diaphragmatic eventration in a dog, withthe aim of increasing the knowledge of this condition in animals and helping others to recognize and treat future cases.Case: A 12-year-old male dachshund presented with severe dyspnea, exercise intolerance and episodes of coughing. Basedon a physical examination and imaging, the main suspicion was a diaphragmatic hernia, and surgery was performed. Whenthe surgeon entered the thoracic cavity, an extremely thin - yet, intact - right hemidiaphragm was observed. The left sideof the diaphragm was normal. A polypropylene mesh was sutured to the affected diaphragm in an attempt to strengthenthe hemidiaphragmatic muscles and prevent further insinuations of viscera into the thoracic cavity. The dog developedbronchopneumonia, postoperatively, and was hospitalized and treated with antibiotics, analgesics and support medication.However, the dog died five days after surgery. A postmortem examination revealed that the right side of the diaphragmwas markedly thin and flaccid. Diaphragm samples were collected for histopathological examination. For comparison, asample of normal diaphragm was collected from a same age, matched dachshund that died due to an unrelated condition.This tissue was called “diaphragm control”, and it was collected in order to compare the histologic features of a normaldiaphragm muscle with the affected one. Histopathology revealed a marked reduction of muscle fibers...

Acquired diaphragmatic eventration in a dog

Background: Diaphragmatic eventration is characterized by weakness of the diaphragmatic muscle, which leads to cranialdislocation of the affected diaphragm and, ultimately, in dyspnea. This condition is rare in humans and even rarer in animals,and may be congenital or acquired. The acquired form is less commom and may be induced by trauma or inflammationand neoplastic invasion of the phrenic nerve. Here, we report a case of acquired diaphragmatic eventration in a dog, withthe aim of increasing the knowledge of this condition in animals and helping others to recognize and treat future cases.Case: A 12-year-old male dachshund presented with severe dyspnea, exercise intolerance and episodes of coughing. Basedon a physical examination and imaging, the main suspicion was a diaphragmatic hernia, and surgery was performed. Whenthe surgeon entered the thoracic cavity, an extremely thin - yet, intact - right hemidiaphragm was observed. The left sideof the diaphragm was normal. A polypropylene mesh was sutured to the affected diaphragm in an attempt to strengthenthe hemidiaphragmatic muscles and prevent further insinuations of viscera into the thoracic cavity. The dog developedbronchopneumonia, postoperatively, and was hospitalized and treated with antibiotics, analgesics and support medication.However, the dog died five days after surgery. A postmortem examination revealed that the right side of the diaphragmwas markedly thin and flaccid. Diaphragm samples were collected for histopathological examination. For comparison, asample of normal diaphragm was collected from a same age, matched dachshund that died due to an unrelated condition.This tissue was called “diaphragm control”, and it was collected in order to compare the histologic features of a normaldiaphragm muscle with the affected one. Histopathology revealed a marked reduction of muscle fibers...(AU)

Vascular and ventilatory mechanical responses in three different stages of pulmonary development in the rabbit model of congenital diaphragmatic hernia

Purpose: To evaluate the vascular ventilatory response in different stages of lung development and to compare them to the neonates with congenital diaphragmatic hernia (CDH) in a rabbit model. Methods: New Zealand rabbits were divided into 8 groups (n=5): E25, E27, E30, and CDH. All groups were ventilated on a FlexiVent (Scireq, Montreal, QC, Canada), compounding the other 4 groups. The CDH surgery was performed at E25 and the harvest at E30. Dynamic compliance (CRS), dynamic elastance (ERS) and dynamic resistance (RRS) were measured every 4 min/24 min. Median wall thickness (MWT) and airspace were measured. ANOVA Bonferroni tests were used to perform statistical analysis. Significance was considered when p 0.05. Results: CRS was higher in E30 compared to all other groups (p 0.05). CRS and RRS of CDH and E27 were similar and were higher in E25 (p 0.05). MWT was decreased according to the gestational age, was increased in E27V and E30V (p 0.05) and decreased in CDHV (p 0.05), airspace was decreased in E25 and increased in all ventilated groups (p 0.05). Conclusions: The ventilation response of congenital diaphragmatic hernia is like the pseudoglandular stage of the lung development. These findings add information about the physiology of pulmonary ventilation in CDH.(AU)

Thoracotomy compared to laparotomy in the traumatic diaphragmatic hernia. Systematic review and proportional methanalysis

Purpose: To evaluate the most used approach to treat traumatic diaphragmatic ruptures, and in which one the requirement to assess the second cavity is more frequent.Methods: Systematic review, observational studies. Outcomes: moment of approach, most commonly via addressed and the requirement to open the other cavity. Bases searched: Lilacs, Pubmed, Embase, Clinicaltrials.gov and Web of Science. Statistical analysis: StatsDirect 3.0.121 software. Results: Sixty eight studies (2023 participants) were included. Approach in acute phase was performed four times more than in chronic phase. Approach: abdominal 65% (IC 95% 63-67%), thoracic 23% (IC 95% 21-24%), abdominal in the acute phase 75% (IC 95% 71-78%), and chronic 24% (IC 95% 19-29%), thoracic in the acute phase 12% (IC 95% 10-14%) and chronic 69% (IC 95% 63-74%). Thorax opening in the abdominal approach: 10% (95% CI 8-14%). Abdomen opening in the thoracic approach: 15% (95% CI 7-24%). Conclusions: The most common approach was the abdominal. The approach in the acute phase was more common. In the acute phase the abdominal approach is more frequent than the thoracic approach. In the chronic phase the thoracic approach is more frequent than the abdominal one. The requirement to open the second cavity was similar in both approaches.(AU)

Herniorrafia diafragmática videoassistida em gato: relato de caso / Videoassisted diaphragmatic hernia repair in a cat: case report

Relata-se um caso de um felino com sinais de dificuldade respiratória havia cerca de 30 dias e emagrecimento progressivo. Ao exame radiográfico torácico e de abdômen, ficou evidenciada perda de definição da linha diafragmática, sendo compatível com hérnia diafragmática. Na laparoscopia, foi observado grande defeito diafragmático, além de estruturas herniadas. Em razão de as vísceras abdominais direcionarem-se ao tórax, dificultando a oclusão do defeito com suturas intracorpóreas, optou-se pela realização de incisão paracostal, procedendo-se à herniorrafia por celiotomia reduzida. A videolaparoscopia permitiu localizar o local herniado e promover a redução dos órgãos envolvidos com mínimo trauma operatório. Logo, mostrou-se como eficaz ferramenta diagnóstica e auxiliar no tratamento de hérnias diafragmáticas crônicas de grande dimensão em gato.(AU)

This is a case report of a cat with signs of respiratory distress for about 30 days and progressive weight loss. The thoracic radiograph and abdomen examination evidencing loss of definition of the diaphragmatic line is compatible with diaphragmatic hernia. In laparoscopy, a large diaphragmatic defect and herniated structures were observed. Since abdominal viscera point towards the chest making occlusion of defective intracorporeal sutures difficult, paracostal incision proceeding to hernia repair by short celiotomy was chosen. Laparoscopy allows for location of herniated place and promotes the reduction of organs involved with minimal surgical trauma. Therefore, it was shown to be an effective diagnostic tool and an aid in the treatment of chronic diaphragmatic hernias of large size in a cat.(AU)

Herniorrafia diafragmática videoassistida em gato: relato de caso / Videoassisted diaphragmatic hernia repair in a cat: case report

Relata-se um caso de um felino com sinais de dificuldade respiratória havia cerca de 30 dias e emagrecimento progressivo. Ao exame radiográfico torácico e de abdômen, ficou evidenciada perda de definição da linha diafragmática, sendo compatível com hérnia diafragmática. Na laparoscopia, foi observado grande defeito diafragmático, além de estruturas herniadas. Em razão de as vísceras abdominais direcionarem-se ao tórax, dificultando a oclusão do defeito com suturas intracorpóreas, optou-se pela realização de incisão paracostal, procedendo-se à herniorrafia por celiotomia reduzida. A videolaparoscopia permitiu localizar o local herniado e promover a redução dos órgãos envolvidos com mínimo trauma operatório. Logo, mostrou-se como eficaz ferramenta diagnóstica e auxiliar no tratamento de hérnias diafragmáticas crônicas de grande dimensão em gato.(AU)

This is a case report of a cat with signs of respiratory distress for about 30 days and progressive weight loss. The thoracic radiograph and abdomen examination evidencing loss of definition of the diaphragmatic line is compatible with diaphragmatic hernia. In laparoscopy, a large diaphragmatic defect and herniated structures were observed. Since abdominal viscera point towards the chest making occlusion of defective intracorporeal sutures difficult, paracostal incision proceeding to hernia repair by short celiotomy was chosen. Laparoscopy allows for location of herniated place and promotes the reduction of organs involved with minimal surgical trauma. Therefore, it was shown to be an effective diagnostic tool and an aid in the treatment of chronic diaphragmatic hernias of large size in a cat.(AU)

Causes of death of domestic cats in a veterinary hospital of Uberlândia, Minas Gerais state: a retrospective study / Causas de óbito em gatos domésticos em um hospital veterinário de Uberlândia, Minas Gerais: estudo retrospectivo

Cats play an important role as pets in the present society. Thus, the knowledge about their main diseases and causes of death is fundamental to prevent various pathologies. However, when dealing with domestic cats there are very few researches in Veterinary Medicine. The aim of this study is to identify the causes of death of cats through a retrospective study of necropsies in the Animal Pathology Laboratory in the Federal University of Uberlândia (Brazil), in a period of 36 years, in which 350 cat necropsies were conducted. The most frequent causes of death of these animals were digestive system diseases (48 cats ­ 13.71%), and among them, feline hepatic lipidosis was the most frequent etiology (18.75%). The second most affected system was the respiratory (10.86%) and acute pneumonia, pulmonary edema, and diaphragmatic hernia were the main diseases to cause death of cats with some kind of disorder in this system. Other decease causes were rabies, squamous cell carcinoma, fibrous osteodystrophy, fractures and traumatism, hypovolemic shock, and feline lower urinary tract disease. This type of analysis can provide basic information about the most common diseases in felines, contributing with veterinarians as they adopt control and prevention actions against diseases.(AU)

Os gatos apresentam papel relevante como animal de estimação na sociedade atual. Neste sentido, o conhecimento das principais enfermidades e causas de morte desses animais é fundamental para prevenção de várias patologias. No entanto, quanto ao gato doméstico, essas pesquisas ainda são escassas na medicina veterinária. Assim, este trabalho realizou um estudo retrospectivo das causas de morte de gatos registradas das necropsias efetuadas pelo Laboratório de Patologia Animal da Universidade Federal de Uberlândia, em um período de 36 anos, no qual 350 gatos foram necropsiados. As doenças do sistema digestivo foram as mais frequentes (48 gatos ­ 13,71%) e destas, a lipidose hepática foi a etiologia de maior ocorrência (18,75%). O sistema respiratório foi o segundo mais afetado (10,86%), sendo pneumonia aguda, edema pulmonar e hérnia diafragmática as principais doenças deste sistema responsáveis pela morte de gatos. Outras causas de óbito importantes foram raiva, carcinoma de células escamosas, osteodistrofia fibrosa, fraturas e traumatismos, choque hipovolêmico e síndrome urológica felina. Este tipo de análise pode fornecer informações básicas sobre as enfermidades que mais acometem os felinos de uma determinada região, contribuindo para que os profissionais médicos veterinários passem a adotar as respectivas ações de prevenção e controle.(AU)

Causes of death of domestic cats in a veterinary hospital of Uberlândia, Minas Gerais state: a retrospective study / Causas de óbito em gatos domésticos em um hospital veterinário de Uberlândia, Minas Gerais: estudo retrospectivo

Cats play an important role as pets in the present society. Thus, the knowledge about their main diseases and causes of death is fundamental to prevent various pathologies. However, when dealing with domestic cats there are very few researches in Veterinary Medicine. The aim of this study is to identify the causes of death of cats through a retrospective study of necropsies in the Animal Pathology Laboratory in the Federal University of Uberlândia (Brazil), in a period of 36 years, in which 350 cat necropsies were conducted. The most frequent causes of death of these animals were digestive system diseases (48 cats ­ 13.71%), and among them, feline hepatic lipidosis was the most frequent etiology (18.75%). The second most affected system was the respiratory (10.86%) and acute pneumonia, pulmonary edema, and diaphragmatic hernia were the main diseases to cause death of cats with some kind of disorder in this system. Other decease causes were rabies, squamous cell carcinoma, fibrous osteodystrophy, fractures and traumatism, hypovolemic shock, and feline lower urinary tract disease. This type of analysis can provide basic information about the most common diseases in felines, contributing with veterinarians as they adopt control and prevention actions against diseases.(AU)

Os gatos apresentam papel relevante como animal de estimação na sociedade atual. Neste sentido, o conhecimento das principais enfermidades e causas de morte desses animais é fundamental para prevenção de várias patologias. No entanto, quanto ao gato doméstico, essas pesquisas ainda são escassas na medicina veterinária. Assim, este trabalho realizou um estudo retrospectivo das causas de morte de gatos registradas das necropsias efetuadas pelo Laboratório de Patologia Animal da Universidade Federal de Uberlândia, em um período de 36 anos, no qual 350 gatos foram necropsiados. As doenças do sistema digestivo foram as mais frequentes (48 gatos ­ 13,71%) e destas, a lipidose hepática foi a etiologia de maior ocorrência (18,75%). O sistema respiratório foi o segundo mais afetado (10,86%), sendo pneumonia aguda, edema pulmonar e hérnia diafragmática as principais doenças deste sistema responsáveis pela morte de gatos. Outras causas de óbito importantes foram raiva, carcinoma de células escamosas, osteodistrofia fibrosa, fraturas e traumatismos, choque hipovolêmico e síndrome urológica felina. Este tipo de análise pode fornecer informações básicas sobre as enfermidades que mais acometem os felinos de uma determinada região, contribuindo para que os profissionais médicos veterinários passem a adotar as respectivas ações de prevenção e controle.(AU)