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Friday, January 2, 2009
Solution for case 9
Radiographic interpretation: Lateral radiograph shows the loss of cardiac silhouette and loss of continuity of the diaphragmatic line. Gas filled loops of intestine are seen in the thorax. There are also poor thoracic details on the ventral caudal thorax. On VD view we can see fissure lines on the left thorax suggestive of the pleural effusion. On the right side of thorax we can see loops of gas filled intestine.

Diagnosis: Traumatic diaphragmatic hernia / pleuroperitoneal hernia.

Treatment and management: Surgery to repair the ruptured diaphragm after patient has been stabilized is the treatment of choice. Oxygen should be supplied if animal is dyspenic. If pleural effusion is present, thoracentasis should be performed. If animal is in shock, should be treated first for shock. If stomach is herniated surgery should be done at earliest possible as gastric dilatation may further compromise the respiration. Mortality is higher when surgery is performed within 24 hours or after 1 year of the injury.

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posted by Dr Banga's Websites @ 12:00 AM  
  • At January 17, 2009 at 4:39 AM, Anonymous Anonymous said…

    on the first radiographic findings it was found out that the abdomen and pelvic region were normal. how come there were hernia after 3 weeks?

  • At January 26, 2009 at 10:33 AM, Blogger Dr Banga's Websites said…

    Yes, this sometimes happens in certain case of DH, the initial Rads are normal because the organs have not displaced and the lent or the rupture is initially small. And as time goes by, due to patient's activities, the liver or intestines herniates through the lent, which may increase the size of the opening and further displacement of the organs, and later appearance of the clinical signs of dyspnea. It may take sometimes 2 years or more for signs of DH (dyspnea etc) to appear after the actual trauma.

  • At January 29, 2016 at 4:26 AM, Anonymous Anonymous said…

    this is a wonderful website

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