Case 12/2020

MDX: Foal, diaphragmatic hernia (congenital) with concurrent aplasia of the pericardium 

Foal, congenital pleuroperitoneal diaphragmatic hernia and left pericardium aplasia. Image a: Lateral view of the coelomic cavities after removal of the left abdominal and thoracic walls; hypoplastic left lung (1); the ventral (2) and the dorsal (3) loop of the left ascending colon; the thoracically translocated (4) and the abdominally located (5) parts of the liver; the diaphragm and area of the dorsal diaphragmatic defect (dotted accolade); the cranial lobe of the right lung which migrated cranial to the heart (white *). Image b: Caudal view of the large diaphragmatic defect with round and bold margins (arrow head) which allows the partial migration of liver and bowel (black *) from the abdomen into the thorax; fibrous aspect of the transdiaphragmatic migrated liver lobe (1) (extraabdominal region) connected by the abdominally located liver (2) by a stalk which contained dilated blood vessels and fibrous connective tissue (white arrow). The white * indicates the caudal pole of the left kidney. Image c: Heart and intestinal loops in situ. The dorsal (1) and the ventral (2) loop of the left ascending colon with the pelvic flexure (black star); small intestine loops (3) in contact with the heart; abundant serous fluid from the fused pleural and pericardial cavities and the partially formed pericardium (arrow head); Image d: The heart and the severely hypoplastic left lung (1) after removal of the intestinal loops; the right lung (2) and the caudal vena cava (3); the arrow indicates the remaining pericardium. Image e: Visceral surface of the liver. The parts of the liver which were translocated in the thoracic cavity (white*) were severely enlarged and exhibited diffuse fibrosis; bar = 10 cm