Just diagnosis a peritoneal-pericardial diaphragmatic hernia (PPDH) incidentally on chest radiographs? Not sure if it need to be cut? PPDH is a developmental malformation that allows abdominal contents to slide through a hernia in the diaphragm directly into the pericardial sac. Clinical signs of PPDH, if there are any in your patient, can be attributed to compression of the heart by contents in the pericardial sac or adverse effects on the organs that are herniating. Check out this veterinary podcast to find out if medical versus surgical management is warranted!