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Life sciences · Journal article
BMC Veterinary Research · July 31, 2026
Early or partial results. Treat as a signal, not a conclusion.
This is a single case report of a 5-year-old horse that presented with progressive neurological signs and severe hepatobiliary dysfunction, found post-mortem to have a chronic diaphragmatic defect with extensive hepatic herniation and histological evidence of hepatic encephalopathy. The case documents a rare and previously poorly characterized equine presentation, but provides no evidence of frequency, prognosis, or management effectiveness.
Case report. Single 5-year-old Mangalarga Marchador stallion evaluated for progressive neurological deterioration. Setting: veterinary clinic (not specified). Diagnosis confirmed by post-mortem examination and histopathology..
5-year-old Mangalarga Marchador stallion presented with obtundation, head pressing, ataxia, and circling; died within 12 h of admission Serum biochemistry showed severe hepatobiliary dysfunction with increased gamma-glutamyl transferase and alkaline phosphatase, hyperbilirubinaemia, and hypertriglyceridaemia Post-mortem revealed chronic pleuroperitoneal diaphragmatic defect with herniation of left lateral, left medial, and quadrate hepatic lobes into thoracic cavity
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This case alerts veterinarians to consider diaphragmatic hernia with hepatic involvement in the differential diagnosis of horses with severe hepatopathy and neurological signs mimicking hepatic encephalopathy, particularly when colic is absent. However, as a single case, it provides no evidence regarding diagnostic accuracy, treatment efficacy, or prognosis.
Single case report documenting a rare clinical presentation of diaphragmatic hernia with hepatic encephalopathy in a horse; no comparative data or control group, limited to descriptive pathology and clinical findings.
As stated by the source record.
Quoted from the source exactly as published.
This case alerts veterinarians to consider diaphragmatic hernia with hepatic involvement in the differential diagnosis of horses with severe hepatopathy and neurological signs mimicking hepatic encephalopathy, particularly when colic is absent. However, as a single case, it provides no evidence regarding diagnostic accuracy, treatment efficacy, or prognosis.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
BACKGROUND: Diaphragmatic hernia in horses is a rare condition, most commonly presenting with signs of colic and, less frequently, respiratory compromise. Hepatic herniation through a diaphragmatic defect with secondary hepatic failure and encephalopathy has rarely been documented in horses. CASE PRESENTATION: A 5-year-old Mangalarga Marchador stallion was evaluated for progressive neurological deterioration, including obtundation, head pressing, ataxia, and circling. Serum biochemistry revealed severe hepatobiliary dysfunction, characterised by increased gamma-glutamyl transferase and alkaline phosphatase activities, hyperbilirubinaemia and hypertriglyceridaemia. The horse died within 12 h of admission. Post-mortem examination revealed a chronic pleuroperitoneal diaphragmatic defect with herniation of the left lateral, left medial, and quadrate hepatic lobes into the thoracic cavity. The herniated portion showed severe atrophy, haemorrhagic necrosis, cholestasis, and ductular proliferation, while the non-herniated hepatic mass exhibited bridging fibrosis and nodular regenerative remodelling. Histopathological examination of the brain confirmed the presence of Alzheimer type II astrocytes in the cerebral cortical grey matter, consistent with hepatic encephalopathy. CONCLUSIONS: This case documents an unusual manifestation of equine diaphragmatic hernia in which extensive chronic hepatic incarceration resulted in severe hepatobiliary dysfunction and hepatic encephalopathy. The findings suggest that diaphragmatic hernia with hepatic involvement should be considered in the differential diagnosis of horses presenting with severe hepatopathy and neurological signs compatible with hepatic encephalopathy, particularly when classical signs of colic are absent.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.