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Novel peritoneopericardial diaphragmatic hernia in a dog
  1. Sam Khan1,2,
  2. David Sajik1,3,
  3. Ignacio Calvo1,4 and
  4. Andrew Phillips1
  1. 1Royal Veterinary College Clinical Services Division, Hatfield, UK
  2. 2Shires Vets, Stone, UK
  3. 3Hamilton Specialist Referrals, High Wycombe, UK
  4. 4VETSIA Hospital Veterinario, Madrid, Spain
  1. Correspondence to Dr Andrew Phillips; aphillips{at}


A 23-month-old German shepherd dog (GSD) with chronic intermittent gastrointestinal signs presented following acute deterioration compatible with gastrointestinal obstruction and suspected peritoneopericardial diaphragmatic hernia (PPDH). Physical examination revealed depression, abdominal pain, decreased pulse quality, reduced heart sounds and tachypnoea with a shallow breathing pattern. Radiography confirmed PPDH and a granular, 1.3 cm mineral opacity cranial to the cardiac silhouette within the cranioventral thorax. Coeliotomy and median sternotomy revealed strangulated jejunum within the cranial mediastinum, cranial to the pericardium. This was resected and herniorrhaphy was performed. Postoperatively the dog became normal. Midline fusion defects, including the pericardium, can be associated with PPDH and in such cases sternotomy may be required. This is the first report of surgical management of strangulated intestine secondary to an initially conservatively managed PPDH. Mineral opacity on radiography associated with PPDH may represent chronic partial obstruction. This possibly represents a second GSD with Cantrell’s pentalogy.

  • abdominal
  • gastrointestinal
  • diagnostic imaging
  • soft tissue surgery
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  • Contributors All authors contributed to the care of the patient. SK and AP took the lead in writing the manuscript and DS and IC provided substantial contributions to the inception and design of the manuscript including critical feedback and research. All authors approved the final version and are accountable to this work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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