Cat hiatial hernia
Publication Date: 2016-03-06
Details
Service Anatomy
Modality: Radiographs
Species: Canine
Area: Head
History
6 year old female intact cat. Owner has noted some episodes of regurgitation.
3 images
Findings
Orthogonal radiographs of the thorax are available for interpretation.
On the right lateral projection there is a large well-defined gas filled lucency superimposed with the caudo-dorsal lung field which is continuous with the stomach and extends over the diaphragmatic crus. On the left lateral projection, a similar but smaller gas opacity is seen. On the VD projection, under the vertebral bodies of T9-T10, the described above structure is seen superimposed with the caudal mediastinum. Furthermore, on the left lateral the esophagus is moderately distended and gas filled from the level of C5 cranially to the level of that structure caudally. The stomach contains a moderate amount of ingesta and gas.
The pulmonary parenchyma, cardiovascular structures and musculoskeletal system are considered to be within normal limits. Between the dorsal spinous processes of T4-T5 there is a mild amount of subcutaneous emphysema. Incidentally on the right lateral projection the brachiocephalic trunk is visualized, this is a normal finding.
Diagnosis
The changes described are most consistent with a hiatial hernia, with associated aerophagia. Subcutaneous emphysema, likely secondary to subcutaneous injection.
Two major type of hiatial hernia have been recognized:
Sliding hiatial hernia, as their name indicates these are dynamic and may have a varying appearance on different projections of the thorax. These represent the caudal esophagus and the cardia sliding into the thorax. They tend to be more often congenital and can be associated with esophageal reflux and potential esophagitis.
Paraesophageal hiatial hernia happens when the fundus, cardia, both or other soft tissue structures herniate through or alongside the esophageal hiatus. Radiographically they are usually static and the gastroesophageal sphincter is a normal position. However, the herniated stomach may cause esophageal compression.
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