Diaphramatic hernia
Publication Date: 2015-02-21
History
Hit by car Shitzu. Difficulty breathing
3 images
Findings
Orthogonal views of the thoracic cavity are available for interpretation.
On the lateral view, there is a generalized increased in opacity within the thoracic cavity causing border effacement to the cardiac silhouette. The portions of the cardiac silhouette that can be identified are within normal limits. Ventrally, there are tubular structures adjacent to the cardiac silhouette. No gas is present within these structures. Adjacent to the diaphragm, within the thorax, a large gas filled structure is noted that seems continuous into the abdominal cavity. This structure likely represents the stomach. The diaphragmatic borders are indistinct in the midthoracic region, at the same level of the stomach. On the ventrodorsal view, the right side of the diaphragm is not visualized, due to the large amount of soft tissue structures extending from the abdomen into the thoracic cavity. Within the lung parenchyma, there are multiple air bronchograms noted in the mid-thoracic region overlying the cardiac silhouette. These changes are likely due to atelectasis. Within the abdomen, there is a large, round soft tissue structure extending from caudal to the liver to the cranial aspect of the urinary bladder. The cranial aspect of this structure has ill-defined linear gas patterns extending to the caudal aspect of the stomach. This structure is causing a mass effect to the kidneys caudally. There is only one loop of bowel noted within the abdominal cavity, which likely represents the colon. On the ventrodorsal view, the head of the spleen is normal in appearance; however the rest of the spleen cannot be identified. The urinary bladder is normal in appearance. No osseous abnormalities are noted on this examination.
Impression: Right-sided diaphragmatic hernia, with herniation of bowel loops, and portions of the stomach. This herniation is causing collapse of the right lung lobes. The described mass within the abdomen may be consistent with a fluid filled pylorus; however, a splenic hematoma cannot be definitively ruled out.
Diagnosis
Diaphragmatic hernia and fluid filled stomach
Notes
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