Caval foramen hernia in a dog: Preoperative diagnosis and surgical treatment

Abstract

A 13-year-old, 5.6-kg castrated-male Maltese was presented for reverse sneezing. A dome-shaped round mass abutting diaphragm was incidentally found ventral to caudal vena cava, which had the same echogenicity and density as that of the liver during ultrasonography and computed tomography, showing isoattenuation with a contrast study. Vascular distribution was identified throughout the mass. A caval foramen hernia (CFH) was diagnosed tentatively, followed by a herniorrhaphy and splenectomy of the chronically congested spleen. The patient had been doing well for 5-month postoperative but died because of aspiration pneumonia. CFH is an extremely rare condition, requiring surgery due to compression of the vena cava. It should be considered as a differential diagnosis when intrathoracic, mass-like lesions are identified near the diaphragm.

Successful early diagnosis and surgical treatment of congenital caval foramen hernia in an 8-month-old mixed breed cat

“…Quite mild symptoms are seen in dogs and cats. Patients are ill with acute cough, reverse sneezing, and chronic cough for 5 weeks (Park et al, 2020;White et al, 2003). Our cat had a cough too, that resolved soon after the surgical treatment.…”

“…Nevertheless, more specific diagnostic images such as a CT scan are highly recommended for a better understanding of the pathology and better surgical treatment options (Kim et al, 2016). Performing procedures such as thoracoscopic diaphragmatic defect repairs would be a challenge without the high-resolution computed tomography images (Park et al, 2020).…”

“…Successful early diagnosis and surgical treatment of congenital caval foramen hernia in an 8-month-old mixed breed cat lung or mediastinal masses, cysts, and granulomas (Ng et al, 2006;Nonaka et al, 2008;Park et al, 2020;Voges et al, 1997). Therefore, the key to understanding this pathology and preventing further confusion is to study it and make the findings available to colleagues.…”

Chronic nonproductive cough in a 9-year-old female spayed Miniature Poodle

“…Caval foramen hernia is a rarely described condition of the dogs and humans where abdominal contents (typically right lateral liver lobe) have herniated through the diaphragmatic caval foramen into the thoracic cavity. [1][2][3] In general, diaphragmatic hernias can be broken down into traumatic and congenital categories. 4 Although it cannot be definitively proven, the hernia in this case is presumed to be congenital given the lack of trauma history and pet ownership from the time of 8 weeks of age.…”

“…The use of ultrasound for diagnosis of diaphragmatic hernia is well described but not specifically validated for caval foramen hernia beyond case reports. 3,4 Ultimately, a triple phase CT was used to obtain a diagnosis in this case and appears to offer a reliable method for diagnosis and characterization of caval foramen hernia. 1 The clinical relevance of caval foramen hernia in dogs is unclear with little information in the veterinary literature on the condition.…”