Congenital retrosternal (Morgagni) diaphragmatic hernias in three horses

Frederik F. Pauwels Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN 47907

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Jan F. Hawkins Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN 47907

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Margaret A. MacHarg Kendall Road Equine Hospital, 10 N 051 Kendall Rd, Elgin, IL 60123

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Ryan D. Rothenbuhler Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN 47907

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Debra K. Baird Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN 47907

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Jason S. Moulton Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN 47907

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Abstract

Case Description—3 horses were examined and treated because of sudden onset of signs of abdominal pain.

Clinical Findings—All horses had a retrosternal (Morgagni) hernia involving the right side of the diaphragm. In each horse, the large colon was incarcerated in a right muscular defect in the diaphragm with a large hernial sac.

Treatment and Outcome—Definitive surgical repair of the hernia was not performed during the initial celiotomy. The hernia was repaired with mesh herniorrhaphy, but without resection of the hernia sac in 2 horses. For 1 horse, conservative management was applied. In the 2 horses treated with surgical correction, no major postoperative complications developed, and all 3 horses have been free of signs of abdominal pain.

Clinical Relevance—Horses with retrosternal hernias involving the diaphragm can develop clinical signs of intermittent obstruction of the large colon and chronic colic. In horses, retrosternal diaphragmatic hernias appear to develop exclusively in the right ventral aspect of the diaphragm and could represent an embryologic defect of diaphragm formation. Affected horses can be successfully treated with mesh herniorrhaphy or, in some instances, with conservative management.

Abstract

Case Description—3 horses were examined and treated because of sudden onset of signs of abdominal pain.

Clinical Findings—All horses had a retrosternal (Morgagni) hernia involving the right side of the diaphragm. In each horse, the large colon was incarcerated in a right muscular defect in the diaphragm with a large hernial sac.

Treatment and Outcome—Definitive surgical repair of the hernia was not performed during the initial celiotomy. The hernia was repaired with mesh herniorrhaphy, but without resection of the hernia sac in 2 horses. For 1 horse, conservative management was applied. In the 2 horses treated with surgical correction, no major postoperative complications developed, and all 3 horses have been free of signs of abdominal pain.

Clinical Relevance—Horses with retrosternal hernias involving the diaphragm can develop clinical signs of intermittent obstruction of the large colon and chronic colic. In horses, retrosternal diaphragmatic hernias appear to develop exclusively in the right ventral aspect of the diaphragm and could represent an embryologic defect of diaphragm formation. Affected horses can be successfully treated with mesh herniorrhaphy or, in some instances, with conservative management.

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