Why is this Pekingese vomiting?
Test your knowledge with the June 2018 Brain Teaser
June 1, 2018
This 10 year old male Pekingese was presented for vomiting.
- Describe the radiograph.
- What is your diagnosis?
- Explain the surgical steps.
- What is a critical precaution preop?
- Intestinal loops are superimposed to the cardiac silhouette. Meanwhile, there are few intestinal loops in the abdomen.
- Peritoneo-pericardial diaphragmatic hernia (PPDH).
- During laparotomy, intestinal loops and other viscera are gently pulled into the abdomen, and the hernia is sutured.
- This is a tricky but vital question. Many PPDHs are incidental findings. After all, this patient has been living with a hernia for 10 years. The challenge is to be convinced that the hernia is truly the cause of the vomiting before surgery is considered.
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