PROGNOSIS OF DIAPHRAGMATIC HERNIA. 
309 
exploratory puncture with Dieulafoy’s aspirator may settle the diagnosis. 
Should the prolapsed viscus be penetrated, fluid, partially-digested food 
will be drawn off. No doubt can then remain as to the condition. 
Prognosis is always unfavourable and treatment unavailable, because 
even though reposition could be effected by performing laparotomy, 
the condition would probably recur, it being impossible to close the 
diaphragmatic opening. 
Schrader saw an uncommon complication in the horse. The 7th rib was 
broken and a fragment had perforated the diaphragm, producing an opening 
Fig. 135.—Diaphragmatic hernia. E, Epiploon ; I G, loop of small intestine; C F, floating 
colon ; R, spleen ; P, lung ; Pe, pericardium. 
through which portions of bowel, omentum, and spleen had passed into the 
thorax, and making their way through the thoracic wall and under the skin, 
had produced a hernia as large as a man’s head just below the left elbow. 
The horse lived for several years, but finally died in consequence of the hernia 
becoming strangulated. 
A case of diaphragmatic hernia is described in Cadiot and Dollar’s “Clinical 
Veterinary Medicine and Surgery,” p. 373, while the condition is fully treated on 
pp. 44 et seq. of the same work. The case referred to is here illustrated (fig. 135). 
The rent in the diaphragm had probably existed for many months, judging 
from the condition of its edges, but at first had only given passage to a few loops 
of small intestine and epiploon. Seven days before death the horse showed 
colic, but apparently recovered. Twelve hours before death, however, it had 
violent pain, which continued until the end. The gastric and splenic herniae 
were probably produced at that time ; soon after becoming herniated the 
stomach ruptured. 
