PPDH
Publication Date: 2017-02-06
History
12 year male castrated shih-tzu. Geriatric check-up. No clinical signs.
5 images
Findings
Orthogonal radiographs of the thorax and abdomen are available for interpretation.
There is normal serosal detail. The cardiac silhouette is markedly enlarged and rounded with a mixture of soft tissue and fat opacities. Fat is visible along the cranial and ventral aspect of the cardiac silhouette. There is a round soft tissue opacity within the cardiac silhouette likely representing the gallbladder. There is a decreased volume of normal liver within the abdomen on all view. On the VD view, the pylorus is cranially displaced into the pericardial sac. Also on the VD view, there is a soft tissue opacity in the right cranial abdomen likely representing either a portion of liver remaining in the abdomen or the splenic tail.
The spleen and gastrointestinal tract are normal. The kidneys and urinary bladder are normal. The skeletal structures are normal.
Diagnosis
Peritoneal-pericardial diaphragmatic hernia. This is likely a congenital problem and is therefore considered incidental at this point. The gallbladder and a portion of liver, as well as the falciform fat, are all herniated. There is also evidence of intermittent herniation of the stomach.
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