Peritoneo pericardial hernioplasty in a 2-month-old Shih Tzu

Peritoneopericardial hernias (PPHs) are congenital malformations characterized by continuity defects between the diaphragm and the peritoneum that allow the transposition of abdominal organs into the thoracic cavity. These malformations can lead to clinical, gastroenterological, and respiratory problems, such as vomiting, dyspnea, and tachypnea. They can be congenital, and patients develop clinical signs at a young age or can be diagnosed as incidental when no complications occur. Furthermore, other malformations, such as cryptorchidism and cardiac interventricular communication, can present with congenital HPP.

This article reports a case of PPH in association with a ventricular septal defect (VSD) in a pediatric canine patient. The dog, a female Shih Tzu, aged 2 months, presented with cyanosis, low weight, decreased body condition score (3/9), and underdevelopment in comparison with other puppies of the same litter. At physical examination, all parameters were within the normal range; however, there was a sound at the base of the heart during auscultation, and echocardiographic examination displayed VSD. Due to the dyspnea, thoracic radiography was performed, and the suspicion of PPH was confirmed. Peritoneopericardial hernioplasty surgery was indicated for a 2-month-old patient. During the surgical procedure, it was not necessary to enter the thoracic cavity in order to close the defect, and suture surgery was performed through the abdominal cavity accessed in the subxiphoidal region. Despite the high risks associated with the procedure, no intraoperative or anesthetic complications occurred.

The hernioplasty procedure was considered successful, and the patient's development and body condition score improvement, with the surgical procedure resolving all signs of respiratory distress.