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

Abstract

Case summaryA 10-month-old domestic shorthair cat was evaluated for severe esophagitis and protracted vomiting and regurgitation secondary to a sliding (type I) hiatal hernia. The hernia and concurrent upper airway obstruction (nasopharyngeal polyp) were diagnosed with a multi-modality approach, including thoracic and abdominal radiographs, abdominal ultrasound, computed tomography and endoscopy. Following unsuccessful attempts at medical management, lower esophageal incompetence was successfully treated by employing a combination of surgical techniques, including herniorrhaphy, esophagopexy and modified (floppy) Nissen fundoplication.Relevance and novel informationA multi-modality imaging approach was valuable in completely assessing the extent of this cat’s disease. Although an untraditional approach, the authors report herein the first clinical description of the use of combined surgical techniques with the floppy Nissen fundoplication technique (an antireflux procedure) in a cat. This procedure was used as a first-line surgical technique in this cat with severe lower esophageal incompetence, and may be a viable option for cases non-responsive to other therapeutic interventions. Further investigation of this surgical technique is warranted.

Hérnia de hiato deslizante em um felino persa: Relato de caso

“…Refluxos são as manifestações clínicas mais comuns em casos de hérnia de hiato, já que qualquer alteração no esfíncter esofágico pode ocasioná-los (Gambino et al, 2015). Ainda que no caso relatado o único sinal clínico observado tenha sido a ocorrência dos refluxos após a alimentação, há muitos casos na literatura que associam quadros respiratórios como sinal da afecção.…”

True Diaphragmatic Hernia (Morgagni Hernia) Incidentally Diagnosed with Positive Contrast Peritoneography in a Cat: A Rare Case Report and a Review

“…Generally, these are not associated with a hernial sac. A few cases of hiatal hernias have been reported in cats [1][2][3][4][5][6][7] and only two cases of herniations through the foramen of the vena cava have been reported in this species [8,9].…”

Surgical Anatomy of the Gastrointestinal Tract in Cats

“…The blood supply of the cardia is provided by the left gastric artery and the satellite vein [ 19 , 20 , 27 ]. The main surgical techniques in this anatomical region include phrenoplasty and esophagopexy performed for the treatment of hiatal hernia [ 21 , 27 , 32 , 33 ]. It is also important during gastrectomy to avoid cardia [ 34 ].…”

“…The main surgical techniques used in this anatomical region include Nissen fundoplication, left-sided gastropexy, gastrotomy, and gastrectomy. More specifically, Nissen fundoplication and modified Nissen fundoplication are surgical techniques described for the surgical treatment of hiatal hernia [ 32 , 37 , 38 , 39 ]. A left-sided fundal gastropexy is also performed alone or in combination with the previously described techniques for the surgical treatment of hiatal hernia in cats [ 33 , 37 , 40 ].…”