Diaphragmatic Hernia Repair

Diaphragmatic hernias are in general classified according to the etiology, since all but the hiatus hernia, all true diaphragmatic hernias are rare.

GENERAL CONSIDERATIONS AND PATOPHYSIOLOGY:

Traumas (especially traffic accidents) are the most common cause of diaphragmatic hernia en dogs and cats (77% to 85% of cases); this is why this document focuses exclusively on the traumatic diaphragmatic hernias.

Indirect trauma to diaphragm is the most common: sudden increased intraabdominal pressure being the glottis open. The increased pressure is commonly over 100 cm H 2 O, while the normal pressure gradient during rest inspiration ranges from 7 to 20 cm d H 2 O.

Diaphragm rupture uses to occur in the most weak sites (muscular portions: costal diaphragmatic muscles; crural muscles are stronger and rarely rupture).

1-3 years old male dogs show higher risk. There is uniform distribution of left or right diaphragm rupture and 15% are bilateral o multiple. Regarding rupture orientation, this is variable: in dogs (40% circumferential, 40% radial and 20% combined), in cats (59% circumferential, 18% radial).

Liver is the organ herniated most commonly (88%), followed by small intestine, stomach, spleen, omentum, pancreas, colon, caecum and uterus. The rupture extension, site and anatomic proximity and ligaments and mesentery length influence which organs will rupture: […]