Repair of a delayed, traumatic dorsal diaphragmatic hernia using a single paracostal approach in a dog

ABSTRACT

Case history

A 1-year-old German Shepherd dog presented for delayed onset of a traumatic, dorsal diaphragmatic hernia of the pars lumborum.

Clinical findings and treatment

Herniorrhaphy via a ventral midline celiotomy (with and without a paracostal extension) were unsuccessful and the hernia recurred. The hernia was successfully repaired using a single lateral paracostal surgical approach. This approach provided excellent exposure and should be considered for dorsal pars lumborum diaphragmatic hernia repairs.

Diagnosis

Dorsal diaphragmatic hernia of the pars lumborum.

Clinical relevance

Whilst uncommon, tears to the dorsal aspect of the diaphragm should be considered as well as the more common radial or circumferential pars costalis tears. Pre-operative computed tomographic imaging can identify the exact location of the hernia in order to allow the best surgical approach to be determined. A lateral paracostal approach should be considered as an alternative to a ventral midline celiotomy with or without paracostal extension for repair of dorsal diaphragmatic hernias affecting the pars lumborum, as it provides excellent exposure. A single lateral paracostal approach has not been reported previously for diaphragmatic hernia repair in dogs.

KEYWORDS:

• Dorsal diaphragmatic hernia
• trauma
• herniorrhaphy
• lateral paracostal approach
• canine