Combined surgical and endoscopic approach for the reduction of a congenital hiatal hernia in a cat: a case report

https://doi.org/10.17221/7385-VETMEDCitation:Pisoni L., Del Magno S., Cinti F., Baron Toaldo M., Joechler M., Pietra M. (2014): Combined surgical and endoscopic approach for the reduction of a congenital hiatal hernia in a cat: a case report. Veterinarni Medicina, 59: 150-156.
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A case of surgical resolution of type I or “sliding” hiatal hernia is reported. A seven-month-old kitten was presented because of abdominal discomfort, accelerated breathing after eating and chronic vomiting. The clinical examination was unremarkable. Thoracic radiographs and gastroscopy led to the diagnosis of type I hiatal hernia. The surgical resolution consisted of hiatal plication, oesophagopexy and left-flank incisional gastropexy. All procedures were carried out using a 6 mm videoendoscope positioned in the stomach to evaluate the right oesophago-gastric junction reduction. One week after surgery there was a recurrence of symptoms and a second laparotomy was performed. During the second surgery additional hiatal plication was necessary and an oesophagopexy was repeated after dissection of the phrenico-oesophageal ligament. Moreover, a new incisional gastropexy was carried out after resolution of the first one. The cat recovered without complications and at one-year follow-up did show no signs related to the hiatal hernia. This communication reports on possible additional surgical techniques in cases of type I hiatal hernia and contributes to an understanding of the importance of oesophagopexy in cases of hiatus malformation.  
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