{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T14:26:39Z","timestamp":1790605599447,"version":"4.1.0"},"reference-count":48,"publisher":"American Animal Hospital Association","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2015,7]]},"abstract":"<jats:p>A 5 mo old male German shepherd dog weighing 15.5 kg was presented with an abdominal wall hernia and exercise intolerance. Physical examination showed a grade II\/VI systolic heart murmur and an area of cutaneous atrophy overlying a midline supraumbilical wall defect. Thoracic radiography, computed tomography, and ultrasound examination revealed a congenital caudal sternal cleft, a supraumbilical diastasis rectus, and a patent ductus arteriosus. Exploratory surgery confirmed defects of the pars sternalis of the diaphragm and caudoventral pericardium and a persistent left cranial vena cava. Those findings were compatible with Cantrell's pentalogy. Surgical treatment included ligation of the patent ductus arteriosus through the sternal cleft, diaphragmatic reconstruction with paracostal extension of the diaphragmatic defect, pericardial and linea alba appositional reconstruction, and primary approximation of the sternal halves. Growth and exercise activity were normal 10 mo after surgery. The discovery of a midline cranial abdominal wall, pericardial, diaphragmatic, or sternal defect should prompt a thorough examination to rule out any possible associated syndrome. Cantrell's pentalogy presents various degrees of expression and is rare in dogs. Management involves early surgical repair of congenital anomalies to protect the visceral structures. The prognosis in dogs with mild forms of the syndrome is encouraging.<\/jats:p>","DOI":"10.5326\/jaaha-ms-6181","type":"journal-article","created":{"date-parts":[[2015,6,17]],"date-time":"2015-06-17T18:31:10Z","timestamp":1434565870000},"page":"279-284","source":"Crossref","is-referenced-by-count":19,"title":["Sternal Cleft Associated with Cantrell's Pentalogy in a German Shepherd Dog"],"prefix":"10.5326","volume":"51","author":[{"given":"Manuel","family":"Benlloch-Gonzalez","sequence":"first","affiliation":[{"name":"From the Surgery Department, CHV Fregis, Arcueil, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrill","family":"Poncet","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"3280","reference":[{"key":"i1547-3317-51-4-279-b01","series-title":"Prenatal development. In Evans HE, ed.: Miller's anatomy of the dog. 2nd ed","first-page":"32","author":"Evans\n              HE.","year":"1993","unstructured":"Evans\n              HE.\n            \n          \n          Prenatal development. In Evans HE, ed.: Miller's anatomy of the dog. 2nd ed. Philadelphia (PA): WB Saunders;1993:32\u201397."},{"issue":"1","key":"i1547-3317-51-4-279-b02","series-title":"Eur J Cardiothorac Surg","first-page":"4","article-title":"Phenotypic spectrum and management of sterna cleft: literature review and presentation of a new series","volume":"41","author":"Torre\n              M,","year":"2012","unstructured":"Torre\n              M, \n            \n              Rapuzzi\n              G, \n            \n              Carlucci\n              M, \n            et al\n          . Phenotypic spectrum and management of sterna cleft: literature review and presentation of a new series. Eur J Cardiothorac Surg2012;41(1):4\u20139."},{"key":"i1547-3317-51-4-279-b03","series-title":"J Am Vet Med Assoc","first-page":"1741","article-title":"Congenital cranioventral abdominal wall, caudal sterna, diaphragmatic, pericardial and intracardiac defects in cocker spaniel littermates","volume":"194","author":"Bellah\n              JR,","year":"1989","unstructured":"Bellah\n              JR, \n            \n              Spencer\n              CP, \n            \n              Brown\n              DJ, \n            et al\n          . Congenital cranioventral abdominal wall, caudal sterna, diaphragmatic, pericardial and intracardiac defects in cocker spaniel littermates. J Am Vet Med Assoc1989;194:1741\u20136."},{"key":"i1547-3317-51-4-279-b04","series-title":"Vet Radiol","first-page":"108","article-title":"Congenital peritoneopericardial diaphragmatic hernia in the dog and cat: a literature review and 17 additional case histories","volume":"21","author":"Evans\n              SM,","year":"1980","unstructured":"Evans\n              SM, \n            \n              Biery\n              DN.\n            \n          \n          Congenital peritoneopericardial diaphragmatic hernia in the dog and cat: a literature review and 17 additional case histories. Vet Radiol1980;21:108\u201316."},{"key":"i1547-3317-51-4-279-b05","series-title":"J Am Anim Hosp Assoc","first-page":"503","article-title":"A technique for surgical correction of peritoneal pericardial diaphragmatic hernia in dogs and cats","volume":"28","author":"Wallace\n              J,","year":"1992","unstructured":"Wallace\n              J, \n            \n              Mullen\n              HS, \n            \n              Lesser\n              MB.\n            \n          \n          A technique for surgical correction of peritoneal pericardial diaphragmatic hernia in dogs and cats. J Am Anim Hosp Assoc1992;28:503\u201310."},{"key":"i1547-3317-51-4-279-b06","series-title":"Vet Rec","first-page":"1112","article-title":"A case of sternal dysraphism and two cases of suspected congenital diaphragmatic hernia in the dog","volume":"77","author":"Foster\n              SJ.","year":"1965","unstructured":"Foster\n              SJ.\n            \n          \n          A case of sternal dysraphism and two cases of suspected congenital diaphragmatic hernia in the dog. Vet Rec1965;77:1112\u20134."},{"key":"i1547-3317-51-4-279-b07","series-title":"Surg Gynecol Obstet","first-page":"602","article-title":"A syndrome of congenital defects involving the abdominal wall, sternum, diaphragm, pericardium, and heart","volume":"107","author":"Cantrell\n              JR,","year":"1958","unstructured":"Cantrell\n              JR, \n            \n              Haller\n              JA, \n            \n              Ravitch\n              MM.\n            \n          \n          A syndrome of congenital defects involving the abdominal wall, sternum, diaphragm, pericardium, and heart. Surg Gynecol Obstet1958;107:602\u201314."},{"key":"i1547-3317-51-4-279-b08","series-title":"Eur J Pediatr","first-page":"29","article-title":"Pentalogy of Cantrell: two patients and a review to determine prognostic factors for optimal approach","volume":"167","author":"van Hoorn\n              JH,","year":"2008","unstructured":"van Hoorn\n              JH, \n            \n              Moonen\n              RM, \n            \n              Huysentruyt\n              CJ, \n            et al\n          . Pentalogy of Cantrell: two patients and a review to determine prognostic factors for optimal approach. Eur J Pediatr2008;167:29\u201335."},{"key":"i1547-3317-51-4-279-b09","series-title":"Pediatr Surg Int","first-page":"156","article-title":"Sternal defects","volume":"5","author":"Shamberger\n              RC,","year":"1990","unstructured":"Shamberger\n              RC, \n            \n              Welch\n              KJ.\n            \n          \n          Sternal defects. Pediatr Surg Int1990;5:156\u201364."},{"key":"i1547-3317-51-4-279-b10","series-title":"Textbook of small animal surgery","first-page":"1353","article-title":"Abdominal wall reconstruction and hernias","author":"Smeack\n              DD.","year":"2012","unstructured":"Smeack\n              DD.\n            \n          \n          Abdominal wall reconstruction and hernias. In: TobiasKM, JohnstonSA, eds. Textbook of small animal surgery. St. Louis (MO): WB Saunders\/Elsevier; 2012:1353\u201379."},{"key":"i1547-3317-51-4-279-b11","series-title":"J Am Vet Med Assoc","first-page":"516","article-title":"Congenital pericardial diaphragmatic hernia and multiple cardiac defects in a litter of Collies","volume":"170","author":"Eyster\n              GE,","year":"1977","unstructured":"Eyster\n              GE, \n            \n              Evans\n              TA, \n            \n              Blanchard\n              GL, \n            et al\n          . 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J Am Vet Med Assoc1989;195:1722\u20136."},{"key":"i1547-3317-51-4-279-b13","series-title":"Pediatrics","first-page":"778","article-title":"Combined congenital defects of the anterior abdominal wall, sternum, diaphragm, pericardium, and heart: a case report and review of the syndrome","volume":"50","author":"Toyama\n              WM.","year":"1972","unstructured":"Toyama\n              WM.\n            \n          \n          Combined congenital defects of the anterior abdominal wall, sternum, diaphragm, pericardium, and heart: a case report and review of the syndrome. Pediatrics1972;50:778\u201392."},{"key":"i1547-3317-51-4-279-b14","series-title":"Pediatr Surg Int","first-page":"428","article-title":"Cantrell's pentalogy. Report of four cases and their management","volume":"12","author":"Fernandez\n              MS,","year":"1997","unstructured":"Fernandez\n              MS, \n            \n              Lopez\n              A, \n            \n              Vila\n              JJ, \n            et al\n          . Cantrell's pentalogy. Report of four cases and their management. Pediatr Surg Int1997;12:428\u201331."},{"key":"i1547-3317-51-4-279-b15","series-title":"Semin Plast Surg","first-page":"107","article-title":"Management of congenital chest wall deformities","volume":"25","author":"Blanco\n              FC,","year":"2011","unstructured":"Blanco\n              FC, \n            \n              Elliot\n              ST, \n            \n              Sandler\n              AD.\n            \n          \n          Management of congenital chest wall deformities. Semin Plast Surg2011;25:107\u201316."},{"key":"i1547-3317-51-4-279-b16","series-title":"Ann Thorac Surg","first-page":"1552","article-title":"Congenital defects of the pericardium","volume":"83","author":"Drury\n              NE,","year":"2007","unstructured":"Drury\n              NE, \n            \n              De Silva\n              RJ, \n            \n              Hall\n              RMO, \n            et al\n          . Congenital defects of the pericardium. Ann Thorac Surg2007;83:1552\u20133."},{"key":"i1547-3317-51-4-279-b17","series-title":"Textbook of small animal surgery","first-page":"1813","article-title":"Cardiac surgery","author":"Orton\n              EC.","year":"2012","unstructured":"Orton\n              EC.\n            \n          \n          Cardiac surgery. In: TobiasKM, JohnstonSA, eds. Textbook of small animal surgery. St. Louis (MO): WB Saunders\/Elsevier; 2012:1813\u201344."},{"key":"i1547-3317-51-4-279-b18","series-title":"Textbook of small animal surgery","first-page":"1845","article-title":"Pericardial surgery","author":"Monnet\n              E.","year":"2012","unstructured":"Monnet\n              E.\n            \n          \n          Pericardial surgery. In: TobiasKM, JohnstonSA, eds. Textbook of small animal surgery. St. Louis (MO): WB Saunders\/Elsevier; 2012:1845\u201353."},{"key":"i1547-3317-51-4-279-b19","series-title":"Arch Surg","first-page":"76","article-title":"Surgical correction of bifid sternum using Marlex mesh","volume":"88","author":"Hoffman\n              E.","year":"1965","unstructured":"Hoffman\n              E.\n            \n          \n          Surgical correction of bifid sternum using Marlex mesh. Arch Surg1965;88:76\u201380."},{"key":"i1547-3317-51-4-279-b20","series-title":"Ann Thorac Surg","first-page":"2291","article-title":"Surgical repair of incomplete cleft sternum and cardiac anomalies in early infancy","volume":"81","author":"Padalino\n              MA,","year":"2006","unstructured":"Padalino\n              MA, \n            \n              Zanon\n              GF, \n            \n              Migneco\n              F, \n            et al\n          . Surgical repair of incomplete cleft sternum and cardiac anomalies in early infancy. Ann Thorac Surg2006;81:2291\u20134."},{"key":"i1547-3317-51-4-279-b21","series-title":"J Pediatr Surg","first-page":"1513","article-title":"Repair of congenital sterna clefts in adolescence and infancy","volume":"29","author":"Knox\n              L,","year":"1994","unstructured":"Knox\n              L, \n            \n              Tuggle\n              D, \n            \n              Knott-Craig\n              CJ.\n            \n          \n          Repair of congenital sterna clefts in adolescence and infancy. J Pediatr Surg1994;29:1513\u20136."},{"key":"i1547-3317-51-4-279-b22","series-title":"J Small Anim Pract","first-page":"313","article-title":"Prevalence, outcome and risk factors for postoperative pyothorax in 232 dogs undergoing thoracic surgery","volume":"54","author":"Meakin\n              LB,","year":"2013","unstructured":"Meakin\n              LB, \n            \n              Salonen\n              LK, \n            \n              Baines\n              SJ, \n            et al\n          . Prevalence, outcome and risk factors for postoperative pyothorax in 232 dogs undergoing thoracic surgery. J Small Anim Pract2013;54:313\u20137."},{"key":"i1547-3317-51-4-279-b23","series-title":"Current techniques in small animal surgery","first-page":"393","article-title":"Thoracic approaches","author":"Dunning\n              D,","year":"1998","unstructured":"Dunning\n              D, \n            \n              Orton\n              CE.\n            \n          \n          Thoracic approaches. In: BojrabJM, EllisonGW, SlocumB, eds. Current techniques in small animal surgery. Baltimore (MD): 1998:393\u20139."},{"key":"i1547-3317-51-4-279-b24","series-title":"J Small Anim Pract","first-page":"715","article-title":"Factors influencing the short-term outcome following thoracic surgery in 98 dogs","volume":"47","author":"Tattersall\n              JA,","year":"2006","unstructured":"Tattersall\n              JA, \n            \n              Welsh\n              E.\n            \n          \n          Factors influencing the short-term outcome following thoracic surgery in 98 dogs. J Small Anim Pract2006;47:715\u201320."},{"key":"i1547-3317-51-4-279-b01","series-title":"Prenatal development. In Evans HE, ed.: Miller's anatomy of the dog. 2nd ed","first-page":"32","author":"Evans\n              HE.","year":"1993","unstructured":"Evans\n              HE.\n            \n          \n          Prenatal development. In Evans HE, ed.: Miller's anatomy of the dog. 2nd ed. Philadelphia (PA): WB Saunders;1993:32\u201397."},{"issue":"1","key":"i1547-3317-51-4-279-b02","series-title":"Eur J Cardiothorac Surg","first-page":"4","article-title":"Phenotypic spectrum and management of sterna cleft: literature review and presentation of a new series","volume":"41","author":"Torre\n              M,","year":"2012","unstructured":"Torre\n              M, \n            \n              Rapuzzi\n              G, \n            \n              Carlucci\n              M, \n            et al\n          . Phenotypic spectrum and management of sterna cleft: literature review and presentation of a new series. Eur J Cardiothorac Surg2012;41(1):4\u20139."},{"key":"i1547-3317-51-4-279-b03","series-title":"J Am Vet Med Assoc","first-page":"1741","article-title":"Congenital cranioventral abdominal wall, caudal sterna, diaphragmatic, pericardial and intracardiac defects in cocker spaniel littermates","volume":"194","author":"Bellah\n              JR,","year":"1989","unstructured":"Bellah\n              JR, \n            \n              Spencer\n              CP, \n            \n              Brown\n              DJ, \n            et al\n          . Congenital cranioventral abdominal wall, caudal sterna, diaphragmatic, pericardial and intracardiac defects in cocker spaniel littermates. J Am Vet Med Assoc1989;194:1741\u20136."},{"key":"i1547-3317-51-4-279-b04","series-title":"Vet Radiol","first-page":"108","article-title":"Congenital peritoneopericardial diaphragmatic hernia in the dog and cat: a literature review and 17 additional case histories","volume":"21","author":"Evans\n              SM,","year":"1980","unstructured":"Evans\n              SM, \n            \n              Biery\n              DN.\n            \n          \n          Congenital peritoneopericardial diaphragmatic hernia in the dog and cat: a literature review and 17 additional case histories. 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J Am Anim Hosp Assoc1992;28:503\u201310."},{"key":"i1547-3317-51-4-279-b06","series-title":"Vet Rec","first-page":"1112","article-title":"A case of sternal dysraphism and two cases of suspected congenital diaphragmatic hernia in the dog","volume":"77","author":"Foster\n              SJ.","year":"1965","unstructured":"Foster\n              SJ.\n            \n          \n          A case of sternal dysraphism and two cases of suspected congenital diaphragmatic hernia in the dog. 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Surg Gynecol Obstet1958;107:602\u201314."},{"key":"i1547-3317-51-4-279-b08","series-title":"Eur J Pediatr","first-page":"29","article-title":"Pentalogy of Cantrell: two patients and a review to determine prognostic factors for optimal approach","volume":"167","author":"van Hoorn\n              JH,","year":"2008","unstructured":"van Hoorn\n              JH, \n            \n              Moonen\n              RM, \n            \n              Huysentruyt\n              CJ, \n            et al\n          . Pentalogy of Cantrell: two patients and a review to determine prognostic factors for optimal approach. Eur J Pediatr2008;167:29\u201335."},{"key":"i1547-3317-51-4-279-b09","series-title":"Pediatr Surg Int","first-page":"156","article-title":"Sternal defects","volume":"5","author":"Shamberger\n              RC,","year":"1990","unstructured":"Shamberger\n              RC, \n            \n              Welch\n              KJ.\n            \n          \n          Sternal defects. 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J Pediatr Surg1994;29:1513\u20136."},{"key":"i1547-3317-51-4-279-b22","series-title":"J Small Anim Pract","first-page":"313","article-title":"Prevalence, outcome and risk factors for postoperative pyothorax in 232 dogs undergoing thoracic surgery","volume":"54","author":"Meakin\n              LB,","year":"2013","unstructured":"Meakin\n              LB, \n            \n              Salonen\n              LK, \n            \n              Baines\n              SJ, \n            et al\n          . Prevalence, outcome and risk factors for postoperative pyothorax in 232 dogs undergoing thoracic surgery. J Small Anim Pract2013;54:313\u20137."},{"key":"i1547-3317-51-4-279-b23","series-title":"Current techniques in small animal surgery","first-page":"393","article-title":"Thoracic approaches","author":"Dunning\n              D,","year":"1998","unstructured":"Dunning\n              D, \n            \n              Orton\n              CE.\n            \n          \n          Thoracic approaches. In: BojrabJM, EllisonGW, SlocumB, eds. Current techniques in small animal surgery. Baltimore (MD): 1998:393\u20139."},{"key":"i1547-3317-51-4-279-b24","series-title":"J Small Anim Pract","first-page":"715","article-title":"Factors influencing the short-term outcome following thoracic surgery in 98 dogs","volume":"47","author":"Tattersall\n              JA,","year":"2006","unstructured":"Tattersall\n              JA, \n            \n              Welsh\n              E.\n            \n          \n          Factors influencing the short-term outcome following thoracic surgery in 98 dogs. 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