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Malformações congénitas associadas a hérnia peritoneopericárdica : estudo retrospetivo
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A hérnia diafragmática peritoneopericárdica (HDPP) ocorre devido a uma malformação congénita do diafragma, podendo ser acompanhada de outras malformações congénitas, nomeadamente hérnia abdominal cranioventral, malformações esternais e malformações cardíacas. O prognóstico de animais diagnosticados com HDPP e com malformações congénitas associadas é, geralmente, bom. No entanto, quando na presença de malformações congénitas cardíacas, o prognóstico torna-se grave ou reservado. O tratamento de uma HDPP inclui métodos cirúrgicos ou conservativos, estando esta decisão dependente dos sinais clínicos apresentados pelo animal, da sua idade e da decisão por parte do cuidador.
O objetivo deste trabalho foi avaliar retrospetivamente uma série de casos clínicos com diagnóstico de HDPP, de forma a relatar as malformações congénitas concomitantes encontradas e avaliar o prognóstico pós-cirúrgico.
Esta série reuniu 40 animais, 16 cães e 24 gatos, sendo a maioria do sexo masculino (n=27; 67,5%), jovens (n=27; 67,5%), e de diferentes raças. 16 casos da amostra apresentavam outras malformações congénitas associadas, predominando o pectus excavatum (n=8), seguido da hérnia umbilical (n=3), criptorquidismo (n=3), defeito septal ventricular (n=2), defeito septal atrial (n=1), dupla câmara ventricular direita (n=1), displasia da válvula tricúspide (n=1), hérnia supraumbilical (n=1), hérnia pleuroperitoneal (n=1) e fenda palatina (n=1).
A cirurgia corretiva da HDPP foi realizada em 17 casos (42%), sendo a maioria jovens (n=10) e sem outras malformações congénitas (n=11). Foi encontrada uma associação significativa entre a não realização de cirurgia corretiva e a ocorrência de morte (p=0.029), existindo benefício desta intervenção em animais com HDPP. O resultados obtidos sugerem que a sobrevivência foi superior nos animais sem malformações congénitas concomitantes e naqueles submetidos a cirurgia corretiva.
ABSTRACT - CONGENITAL DEFECTS ASSOCIATED WITH PERITONEOPERICARDIAL DIAPHRAGMATIC HERNIA: RETROSPECTIVE STUDY - Peritoneopericardial diaphragmatic hernia (PPDH) results from a congenital defect of the diaphragm which can be accompanied by other congenital defects, namely cranioventral abdominal hernia, sternal and cardiac defects. The prognosis of animals diagnosed with PPDH and associated congenital defects is generally good. However, when in the presence of congenital cardiac defects, the prognosis becomes severe or reserved. The treatment of a HDPP includes surgical or conservative methods, depending on the clinical signs, age and guardian’s decision. The aim of this study was to retrospectively evaluate a series of clinical cases diagnosed with PPDH, in order to report the concomitant congenital defects found and to evaluate the post-surgical prognosis. This series gathered 40 animals, 16 dogs and 24 cats, most of them male (n=27; 67.5%), young (n=27; 67.5%), and of different breeds. 16 cases in the sample had other associated congenital defects, predominantly pectus excavatum (n=8), followed by umbilical hernia (n=3), cryptorchidism (n=3), ventricular septal defect (n=2), atrial septal defect ( n=1), double-chambered right ventricle (n=1), tricuspid valve dysplasia (n=1), supraumbilical hernia (n=1), pleuroperitoneal hernia (n=1) and cleft palate (n=1). Corrective surgery for PPDH was performed in 17 cases (42%), most of them young (n=10) and without other congenital malformations (n=11). A significant association was found between not performing corrective surgery and the occurrence of death (p=0.029), with a benefit from this intervention in animals with PPDH. The results obtained suggest that survival was higher in animals without concomitant congenital defects and in those undergoing corrective surgery.
ABSTRACT - CONGENITAL DEFECTS ASSOCIATED WITH PERITONEOPERICARDIAL DIAPHRAGMATIC HERNIA: RETROSPECTIVE STUDY - Peritoneopericardial diaphragmatic hernia (PPDH) results from a congenital defect of the diaphragm which can be accompanied by other congenital defects, namely cranioventral abdominal hernia, sternal and cardiac defects. The prognosis of animals diagnosed with PPDH and associated congenital defects is generally good. However, when in the presence of congenital cardiac defects, the prognosis becomes severe or reserved. The treatment of a HDPP includes surgical or conservative methods, depending on the clinical signs, age and guardian’s decision. The aim of this study was to retrospectively evaluate a series of clinical cases diagnosed with PPDH, in order to report the concomitant congenital defects found and to evaluate the post-surgical prognosis. This series gathered 40 animals, 16 dogs and 24 cats, most of them male (n=27; 67.5%), young (n=27; 67.5%), and of different breeds. 16 cases in the sample had other associated congenital defects, predominantly pectus excavatum (n=8), followed by umbilical hernia (n=3), cryptorchidism (n=3), ventricular septal defect (n=2), atrial septal defect ( n=1), double-chambered right ventricle (n=1), tricuspid valve dysplasia (n=1), supraumbilical hernia (n=1), pleuroperitoneal hernia (n=1) and cleft palate (n=1). Corrective surgery for PPDH was performed in 17 cases (42%), most of them young (n=10) and without other congenital malformations (n=11). A significant association was found between not performing corrective surgery and the occurrence of death (p=0.029), with a benefit from this intervention in animals with PPDH. The results obtained suggest that survival was higher in animals without concomitant congenital defects and in those undergoing corrective surgery.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Hérnia diafragmática peritoneopericárdica malformações congénitas diafragma cão gato peritoneopericardial diaphragmatic hernia congenital defects diaphragm dog cat
Contexto Educativo
Citação
Curtinhal IT 2021. Malformações congénitas associadas a hérnia peritoneopericárdica : estudo retrospetivo [dissertação de mestrado]. Lisboa: FMV-Universidade de Lisboa.
Editora
Universidade de Lisboa, Faculdade de Medicina Veterinária