Remnant parietal serosa detection in a cat with true diaphragmatic hernia using computed tomography

Abstract

A 4-year-old cat was referred for a suspected pulmonary mass. True diaphragmatic hernia presence was diagnosed via computed tomography (CT). There was a thin membrane covering the diaphragmatic defect. The membrane was thinner than the diaphragm. After contrast injection, the membrane was less enhanced than that of the normal diaphragm. The membrane was identified as a remnant of the parietal pleura. In addition, contrast-enhanced CT images provided clarity in viewing the herniated liver and falciform fat. A thinner membrane, covering the diaphragmatic defect, and attached to the thicker normal diaphragm, is considered a unique CT feature of true diaphragmatic hernia.

True Diaphragmatic Hernia (Morgagni Hernia) Incidentally Diagnosed with Positive Contrast Peritoneography in a Cat: A Rare Case Report and a Review

“…To the best of our knowledge, this is the first instance where the term "Morgagni hernia" is employed in veterinary medicine to describe this congenital anomaly. Nevertheless, six cases previously reported in cats [11,12,15,16,19,20]-including the cases by Vosges et al [11] and Carriou et al [15]-along with three cases in dogs [21,22] appear to be consistent with a Morgagni hernia, as the radiological images are directly comparable to those of the current case.…”

“…The organs typically involved include a small portion of the liver in 10 out of 13 cases (77%) [10,12,[14][15][16][17][18][19][20], or the falciform ligament in 4 out of 13 cases (30%) [11,13,19], including the current case. In the case documented by Lee et al [19], both the liver and the falciform fat were present; in the present report, a part of the falciform ligament and a part of the omentum were involved. In humans, the intrathoracic hernial sac often encompasses the omentum and the falciform ligament [33].…”

“…True diaphragmatic hernias are infrequently documented in the veterinary literature. We have cataloged 12 individual reports in cats [10][11][12][13][14][15][16][17][18][19][20] and 4 individual reports in dogs [21][22][23]. To our knowledge, no cases have been reported in a case series.…”

“…The cases reported in the veterinary literature are all serendipitous discoveries during the investigation of symptoms not typically associated with diaphragmatic hernias: intermittent diarrhea [11], hyperthyroidism [12], cough [14], acute neurological deterioration [15], squamous cell carcinoma of the ears [13], diabetes mellitus [18], routine health inspection [19], and intermittent vomiting [20].…”

“…Given their distinct margins and thoracic location, it is understandable that these hernias are sometimes misidentified as pulmonary masses [11,14,19].…”