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

Authors: O'Byrne KL, Smalle T, Ryan SD
Publication: New Zealand Veterinary Journal, Volume 70, Issue 1, pp 55-62, Jan 2022
Publisher: Taylor and Francis

Animal type: Dog
Article class: Clinical Communication

---

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

---