Successful repair of diaphragmatic hernia with simultaneously performed thoracotomy and median laparotomy in a horse

Abstract

This report describes the successful treatment of a chronic diaphragmatic hernia in a 2.5-year-old crossbred gelding. The tear remained unidentified until colic signs and dyspnoea appeared. In this case, an unconventional surgical approach was used. Based on the clinical findings, diaphragmatic herniation with non-strangulating large intestinal involvement was diagnosed. From the ventral midline approach, a diaphragmatic tear with a diameter of 20 cm in the left ventral area was found together with a fractured 10th rib. Repositioning of the large colon was unsuccessful through the ventral midline approach, therefore lateral thoracotomy via rib resection was performed without closing the ventral midline incision. The simultaneous laparotomy with thoracotomy can be a useful approach in the treatment of diaphragmatic hernias when the tear is located ventrally. Advantages of the described surgical technique were easier reposition of the herniated intestine and good access to close the diaphragmatic tear, and disadvantage was the longer surgical time.