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Oscar was presented to us on 21st of september 2009. He was extremely lethargic. From the outset it was obvious that his breathing was laboured and while examining him he was starting to deteriorate. He had a wound on his back leg and also had scuffed claws. This was highly suggestive of a car accident and with his laboured breathing I was worried he may have some major damage to his chest. Oscar was admitted straight away for oxygen therapy, pain relief and X-rays.
X-ray showing Herniated Abdominal Contents - Image 1
X-ray showing Herniated Abdominal Contents - Image 2
Oscar’s X-rays show that his diaphragm was ruptured and as you can see (on our labelled X-rays pictures above) part of his abdominal contents were now in his right chest cavity. This explained the laboured breathing. A ruptured diaphragm will occur after a major impact (normally with a car) that causes the diaphragm to tear. No other injuries were evident apart from the small cut on his leg. The diaphragm is a sheet of muscle that separates the abdomen (tummy) from the thorax (chest) and its major role is to control breathing. Without it, Oscar was struggling to keep himself alive and hence immediate surgery was the top priority.
For this particular operation, our nurses had to regularly pump the oxygen and anaesthetic gas mixture into Oscar’s chest to ‘breathe’ for him, because, without a fully working diaphragm his lungs would naturally collapse. This adds to the complexity of the whole procedure. The operation required 4 people: one monitoring Oscar, one breathing for him and 2 vets performing the surgery!
Surgery Underway - Image 3
His liver and some of his intestines had moved through the diaphragm tear into the chest cavity, so they had to be brought out and replaced into their rightful place in the abdomen. Once this had been done we started to suture (sew) the hole back together and it was a big hole! Half of his diaphragm had been ruptured.
Diaphragm partially repaired - Image 4
The last 2-3 sutures are pre-placed so that we can squeeze all the excess air out of the chest and tighten the sutures at the same time (so as not to leave any free air in the chest cavity, which could once more lead to his lungs collapsing).
Last few stitches replaced - Image 5
After the operation we took another X-ray to make sure all was okay. As you can see in the image below there is a small amount of air left in the chest cavity. This will resorb after time. It is also evident that there are no longer any abdominal contents left in the chest cavity!
Post operation X-ray - Image 6
Oscar recovered steadily over a period of a couple of hours after the operation, which included the changeover from his reliance on us to breathe for him, to his ability to breathe for himself again. He did very well and was able to go home the next day, and is well on the way to a full recovery. Get well soon Oscar!
Oscar receiving a post-op check - Image 7
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