Comparison of four ultrasonographic approaches for the diagnosis of acquired reticular diaphragmatic hernia in Bovidae

Abstract

The aim of this study was to look at four ultrasonographic approaches that diagnose acquired reticular diaphragmatic hernia(RDH) using either left or right caudal thoracic approaches (4th/5th intercostal space) and compare them to those made more cranially(1st/2nd intercostal space). Each sonographic observation was made in 27 unsedated, standing animals (22 buffaloes and 5 cattle) thatwere surgically confirmed for RDH. Using the right caudal thoracic approach, the herniated reticulum was seen as medial to the thoracicwall at a depth of 3 5 cm and adjacent to the cardiac silhouette. With the left caudal thoracic approach, the herniated reticulum wasseen at a depth of 10 15 cm beyond the heart, which acted as a useful acoustic window. Compared to the nonherniated reticulum, theherniated reticulum had subjectively reduced amplitude or no contractions. The right cranial thoracic approach detected a significantly(P < 0.01) larger herniation (22.60 ± 1.65 cm) than that of the smaller hernia (14.09 ± 0.82 cm) when measured with radiographs.However, the left cranial thoracic approach was able to diagnose RDH in one buffalo with extensive herniation. In conclusion, RDH wasconsistently demonstrated ultrasonographically using caudal thoracic approaches, whereas the cranial thoracic approaches were only ofvalue in Bovidae with extensive reticular herniation.