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Peritoneopericardial diaphragmatic hernia (PPDH) in a 12 year old FS DLH cat

Case Study

Peritoneopericardial diaphragmatic hernia (PPDH) in a 12 year old FS DLH cat

A 12-year-old SF DLH was presented for evaluation of a suspected mass in the caudal thorax. CBC and urinalysis were both within normal limits. Serum biochemistry showed elevated ALT and AST activity. 

A 12-year-old SF DLH was presented for evaluation of a suspected mass in the caudal thorax. CBC and urinalysis were both within normal limits. Serum biochemistry showed elevated ALT and AST activity. 

DX

Peritoneal pericardial diaphragmatic hernia

Sonographic Differential Diagnosis

Peritoneal pericardial diaphragmatic hernia of the liver. This appears stable. Concurrent inflammatory hepatopathy is likely. The elevations of the liver enzymes are likely unrelated to the diaphragmatic hernia.

Image Interpretation

The liver in this patient impinged upon the heart directly. Separation from the pericardium was not visible. This is consistent with pericardial diaphragmatic hernia of the liver. This condition currently appears stable. No free fluid or associated inflammation was noted. The gallbladder was unremarkable other than being pulled cranially.

Outcome

None

Comments

Hypoallergenic diet, 10-14 days of Metronidazole combination therapy, and reassessment of the liver values in 4-6 weeks would be recommended. 

Clinical Differential Diagnosis

Caudal abdominal mass – diaphragmatic hernia, neoplasia, granuloma, abscess. Elevated liver values – cholangio-hepatitis complex, neoplasia, trauma, granulomatous disease.

Sampling

FNA of the liver was recommended, however, no sampling was done.

Patient Information

Patient Name : Annie S
Gender : Female, Spayed
Species : Feline
Type of Imaging : Ultrasound
Status : Complete
Liz Wuz Here : Yes
Code : 10_00058

Images

pcdh_feline_stable

Blood Chemistry

  • ALT (SGPT), High
  • AST (SGOT), High