Concurrent Traumatic Peritoneopericardial Diaphragmatic Hernia and Multiple Fractures Following a Fall in a Cat

Background: Peritoneopericardial diaphragmatic hernia (PPDH) is a rare congenital or acquired condition characterized by herniation of abdominal organs into the pericardial sac through a defect in the diaphragm. Traumatic PPDH associated with multiple fractures is uncommon in cats, especially following falls from height. This report describes the clinical, imaging, and surgical findings of such a case. Case presentation: A two year old male domestic shorthair cat (۴ kg) was presented after falling from the third floor with dyspnea, lameness, and pain in the left hind limb. Radiography revealed severe pleural effusion, pneumothorax, lung lobe collapse, and multiple fractures including distal spiral fracture of the left femur, fourth metacarpal, and bilateral third metatarsal bones. Point-of-care ultrasound (POCUS) confirmed pleural effusion and hepatic parenchyma adjacent to the cardiac silhouette, suggestive of diaphragmatic rupture. Exploratory midline laparotomy confirmed hepatic lobe entrapment within the pericardial sac (PPDH). The herniated lobes were gently withdrawn, and the diaphragmatic defect was repaired with absorbable PDS sutures, followed by thoracocentesis. Results & Conclusion: The cat recovered uneventfully with resolution of dyspnea after surgery. Intensive postoperative care was provided until orthopedic stabilization of the femoral fracture was performed. Pulmonary and orthopedic conditions improved progressively. This case emphasizes the importance of POCUS in early diagnosis of traumatic PPDH in cats following high rise syndrome. Prompt surgical correction and supportive postoperative care can result in favorable outcomes despite concurrent severe fractures.

کلیدواژه ها:

Peritoneopericardial Diaphragmatic Hernia ، Cat ، Trauma ، POCUS ، Orthopedic Fracture