Peritoneopericardial diaphragmatic hernia and concomitant lung lobe torsion in a dog

Abstract

A 7‐month‐old, male, entire Weimaraner was referred for surgical repair of a peritoneopericardial diaphragmatic hernia. Thoracic radiographs confirmed a peritoneopericardial diaphragmatic hernia and showed a vesicular emphysema pattern, suggestive of lung lobe torsion. Herniorrhaphy to repair the peritoneopericardial diaphragmatic hernia was performed, and exploratory median sternotomy revealed a torsion of the right middle lung lobe, as well as complete atelectasis of the right caudal lung lobe. Lung lobectomies were performed, and an autologous pericardial flap was used to repair the diaphragmatic defect. A second operation was required because of the suspicion of active bleeding. It was discharged after 6 days of hospitalisation. It is our hypothesis that peritoneopericardial diaphragmatic hernia contributed to the lung lobe torsion due to alterations in the spatial dimensions of the thoracic cavity. Lung lobe torsion has been previously associated with traumatic diaphragmatic herniation in dogs and cats, and has also been reported in a cat with a congenital peritoneopericardial diaphragmatic hernia and chylothorax.

Hypertrophic osteopathy in a dog associated with chronic lung lobe torsion

“…In LLT, pleural effusion is thought to occur secondary to pulmonary venous hypertension and decreased lymphatic drainage, as well as inflammation. 33,47 The authors suspect that pleural effusion was likely initially present in this patient, but resolved given The time for development of secondary HO is unknown, although previous literature supports the notion that chronicity of the underlying disease is required. 24,48,49 In this case, chronicity of the LLT was confirmed during surgery and with histopathology findings of marked interstitial and pleural mature fibrous adhesions.…”

“…In that study—in agreement with this case—pleural effusion was not observed. In LLT, pleural effusion is thought to occur secondary to pulmonary venous hypertension and decreased lymphatic drainage, as well as inflammation 33,47 . The authors suspect that pleural effusion was likely initially present in this patient, but resolved given the chronicity of inflammation, presence of focal adhesions and/or accommodation to chronically impaired venous and lymphatic drainage.…”