Rocky’s PPDH

“Rocky” is a two-year-old male neutered Domestic Shorthair that presented to Hinsdale Animal Hospital for an acute history of vomiting. Rocky was adopted with his sibling as a kitten from the local humane society. He has always been smaller than his sibling, and more of a picky eater, but was believed to be in generally good health. On the day of presentation, Rocky had vomited approximately 10 times and the owners believed that he has ingested some ribbons they saw him playing with earlier in the week. Radiographs were performed revealing an enlarged cardiac silhouette with areas of lucency consistent with loops of intestines overlying. These findings are consistent with a pericardio-peritoneo-diaphragmatic hernia (PPDH).

PPDH can occur with trauma or, as in this case, is a congenital abnormality that occurs in embryonic development when there is incomplete formation of the septum transversum. This leads to incomplete formation of the diaphragm and hence the ability of abdominal organs such as the liver, intestines, spleen or stomach to move into the pericardial sac.

Since Rocky was showing clinical signs (vomiting) due to this abnormality, surgery was performed. The abdominal organs were retracted via a midline laparotomy and the rent in the diaphragm repaired surgically.

Rocky went on to make a complete recovery.

Pre-Operative Radiographs:

4 hours post-operatively

4 weeks post-operative radiograph