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The stomach was reduced by gentle traction. Abdominal exploration revealed that the dog's entire stomach protruded into the thoracic cavity through the esophageal hiatus. The patient was continuously monitored, including electrocardiography, capnography, pulse oximetry and blood pressure measurements.Ī ventral midline celiotomy was made. General anesthesia was maintained with inhaled isoflurane in oxygen under intermittent positive pressure ventilation.ĭuring surgery, a constant-rate infusion of fentanyl (0.05 μg/kg/min) and lactated Ringer's solution (10 ml/kg/hr) were administered. The dog was also given robenacoxib (Onsior-Novartis Animal Health 1 mg/kg subcutaneously). After initial stabilization, the dog was given acepromazine (0.02 mg/kg intravenously) and a bolus of fentanyl (2 μg/kg intravenously) before induction with propofol (2 mg/kg intravenously to effect) to allow for tracheal intubation. The dog was treated with lactated Ringer's solution (20 ml/kg intravenously) for 30 minutes. The stomach is not evident in the cranial abdomen.Fluids and anesthesia Ill-defined soft tissue opacity prevents the clear appearance of the cardiac apex and cupula. A compartmentalized gas-filled structure (arrows) is seen in the middle and caudal thorax. A lateral radiograph of the thorax and cranial abdomen of an 8-year-old Shar-Pei. On thoracic radiography, a gas-filled stomach in the thoracic cavity, overlying the diaphragmatic margin, was observed ( Figure 1). Complete blood count and serum chemistry profile results were normal. No history of trauma was recorded.Ī physical examination revealed that the dog was in good body condition and mildly dyspneic. Charlotte,NC: Surgical Section of the National Medical Association July 26, 2011.An 8-year-old 29-kg intact male Shar-Pei was presented for evaluation of acute respiratory distress and vomiting of one day's duration. Surgical Approach, Risks, and Outcomes Of Paraesophageal Hiatal Hernia Repair: An Analysis Of The National Inpatient Sample Database. Surgical management of esophageal reflux and hiatus hernia. Paraesophageal hernias: operation or observation?. Read it at Google Books - Find it at Amazon Bacterial infections of the lungs and bronchial compressive disorders. (Eds), Elsevier Mosby, Philadelphia 2004. In: Surgical Foundations: Essentials of thoracic surgery, Kaiser, LR, Singal, S. Guidelines for the management of hiatal hernia.
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doi:10.4240/wjgs.v3.i2.29 - Free text at pubmed - Pubmed citation Herniated pancreatic body within a paraesophageal hernia. Hernias (hiatal, traumatic, and congenital) In: Berk JE, editor. Approaches to the diagnosis and grading of hiatal hernia.
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type I - sliding hernia: GEJ migrates into the posterior mediastinum through the esophageal hiatus.Generally, a hiatus hernia is classified into four types. In contrast, a sliding hiatus hernia does not have a hernia sac and slides into the chest since the gastro-esophageal junction (GEJ) is not fixed inside the abdomen. In para-esophageal hernia, there is an upward herniation of the gastric fundus above a normally positioned gastroesophageal junction.Ī para-esophageal hernia includes a peritoneal layer that forms a true hernia sac, distinguishing it from the more common sliding hiatus hernia. recurrent aspiration, pneumonia, and chronic cough.associated with a large para-esophageal hernia.compression of the esophagus by the intrathoracic stomach.
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diaphragmatic impingement on the stomach.