Long-Term Survival and Successful Surgical Correction of a Chronic Peritoneopericardial Diaphragmatic Hernia in a Persian Cat

Background: Peritoneopericardial diaphragmatic hernia (PPDH) is a congenital anomaly characterized by a communication between the peritoneal and pericardial cavities, allowing abdominal organs to herniate into the pericardium. Although PPDH can remain asymptomatic for years, chronic cases often lead to respiratory distress, gastrointestinal dysfunction, or cardiac compression. This report describes an exceptional case of a Persian cat that survived five years with an untreated PPDH and underwent successful surgical correction after bilateral pulmonary atelectasis had developed. Methods: A ۵-year-old male Persian cat was presented with progressive dyspnea, reduced activity, and occasional anorexia in PETSAR veterinary polyclinic. The owner reported that the cat had been diagnosed with PPDH as a kitten but had declined surgical correction. Thoracic radiographs and computed tomography revealed loss of diaphragmatic continuity and displacement of liver and intestinal loops into the pericardial sac, causing significant bilateral pulmonary atelectasis and compression of the cardiac silhouette. Routine hematology and biochemistry profiles were within normal limits. Following stabilization with oxygen therapy and corticosteroids, the cat was anesthetized for herniorrhaphy via a ventral midline celiotomy. Results: Intraoperative findings confirmed herniation of hepatic lobes and omentum into the pericardium through a ۴ cm congenital diaphragmatic defect. The organs were carefully reduced, and the defect was closed using interrupted polypropylene sutures. Postoperative radiographs demonstrated re-expansion of both lung lobes with normal cardiac positioning. The cat recovered uneventfully, showing marked improvement in respiratory function and activity levels. On six-month follow-up, the patient was clinically normal, active, and in excellent health condition. Conclusion: This case represents a rare example of long-term survival in an untreated PPDH and emphasizes that even chronic cases can have an excellent prognosis following surgical correction. Advanced imaging and careful perioperative management were critical to successful outcome. This report underlines the resilience of feline patients and the importance of reconsidering surgical intervention even in longstanding congenital conditions.

کلیدواژه ها:

cat ، peritoneopericardial diaphragmatic hernia ، Persian ، chronic case ، surgery ، recovery