Intrathoracic Ectopic Liver in a Dog

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

“…A herniated liver is commonly congested or swollen and can induce hepatic venous stasis, hepatic necrosis, biliary tract obstruction, and jaundice, but it usually remains viable, which leads to a lobectomy that is rarely necessary [ 8 ]. According to previous reports of CFH or intrathoracic EL, most cases revealed normal hepatic tissue without malignancy in histopathology [ 1 , 4 , 5 , 6 , 7 , 11 , 12 , 14 ]. As ischemia-, necrosis-, or incarceration-associated proliferation of endogenous Clostridia and toxin release into the bloodstream after repositioning might be concerned, prophylactic and therapeutic antibiotics such as penicillin can be administered [ 8 ].…”

“…A triple-phase CT angiography determined a CFH preoperatively by clarifying its anatomical relation to abutting structures (diaphragm, CVC, and abdominal liver) and its vascularity extending into the herniated liver. An intrathoracic liver is probably associated with a DH, CFH, or intrathoracic EL [ 3 , 5 , 6 , 9 , 11 , 13 , 14 ]. Occasionally, it can be difficult to differentiate them from each other preoperatively [ 3 , 5 , 6 ], one CFH was diagnosed intraoperatively [ 3 ].…”

“…A caudal median sternotomy could have been performed instead of paracostal elongation. Most cases of CFH and intrathoracic EL have been approached using thoracotomy in both humans and dogs [ 3 , 4 , 6 , 7 , 14 ]. It allows for inspection of the convex pleural surfaces and good visual exposure of herniated organs and diaphragmatic tears, which permits easy breakdown of adhesion [ 3 , 8 ].…”

“…However, they have been reported more than CFHs in both human and veterinary medicine, although the majority of ELs are found in the abdominal cavity near the liver (gallbladder, spleen, pancreas, omentum, adrenal gland) [ 1 , 3 , 10 , 11 , 12 ]. Intrathoracic ELs can be congenitally associated with a defect during embryological development, secondary acquisition due to trauma or previous repair of DH, or hematogenous dissemination of the native liver during transplantation surgery [ 1 , 3 , 6 , 12 ]. It occurs with or without diaphragmatic defects, and it may or may not have a connecting pedicle to the liver [ 1 , 3 , 6 ].…”

“…Intrathoracic ELs can be congenitally associated with a defect during embryological development, secondary acquisition due to trauma or previous repair of DH, or hematogenous dissemination of the native liver during transplantation surgery [ 1 , 3 , 6 , 12 ]. It occurs with or without diaphragmatic defects, and it may or may not have a connecting pedicle to the liver [ 1 , 3 , 6 ]. DE occurs when diaphragmatic muscles are malpositioned with subtotal diaphragmatic tears but intact serosa of the thoracic surface of the diaphragm [ 9 ].…”