Hiatal Hernia in the Dog: A Clinical Report of Four Chinese Shar Peis

Abstract

Four Chinese shar pei littermate puppies were presented for vomiting, regurgitation, hypersalivation, and poor growth. Diagnosis of hiatal hernia was made for each of the four dogs based on survey radiographs and barium esophagram studies. All dogs initially underwent medical therapy, to which only one dog responded. All dogs underwent surgical treatment, which included manual hernia reduction followed by phrenoplasty, esophagopexy, and left incisional gastropexy, 5 to 40 days following initiation of medical therapy. The three surgical techniques described eliminated the need to enter the pleural cavity and offered excellent long-term results with no recurrence of clinical signs following surgery.

Prospective evaluation of surgical management of sliding hiatal hernia and gastroesophageal reflux in dogs

“…Sliding hiatal hernia (SHH) can arise as a congenital anomaly, reported most commonly in young Shar Peis, or as an acquired condition secondary to airway obstructive disease or neuromuscular disorders affecting the diaphragm . It is often accompanied by gastroesophageal reflux (GER) although some degree of GER is considered a normal finding in dogs .…”

Hiatal hernia in a five‐month‐old Bulldog

“…The technique also results in a pneumothorax from penetration into the pleural cavity and thus requires positive pressure ventilation and restoration of the negative pressure within the thorax following the hernia repair. In a study of four Shar Pei dogs with hiatal hernias by Guiot in 2008, successful phrenicoplasty was reported without transection of the phrenico-oesophageal ligament (Guiot and others 2008). This technique involved the placement of 2/0 monofilament non-absorbable sutures dorsal and ventral to the crura surrounding the hiatus and was the procedure followed in this case study.…”

“…Reported clinical signs include regurgitation, vomiting, dyspnoea and hypersalivation (Bright and others 1990, Guiot and others 2008). In cases of congenital hiatal hernia, the clinical signs may be observed immediately after weaning onto solid food and are usually seen before the age of one year (Keeley and others 2008).…”

Repair of a sliding (type I) hiatal hernia in a cat via herniorrhaphy, esophagoplasty and floppy Nissen fundoplication

“…22 Described techniques include herniorrhaphy, gastropexy, esophagopexy, antireflux procedures and feeding tubes, or a combination thereof. 23 Hiatal reduction alone may be insufficient. 16 …”

“…24 Some authors propose that these techniques are surgically demanding, lend themselves to higher complication rates, and that the rationale for pursuing sphincter enhancement techniques is a failure of response to previous repositioning efforts. 2,22,23 …”