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RUSVM Small Animal Surgery 2017 > Hernia Surgery > Flashcards

Hernia Surgery Flashcards

1
Q

Hernia

A

Protrusion of contents through a defect in the wall of the cavity in which it normally lies

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2
Q

What type hernia has no sac?

A

Traumatic Hernia

False Hernia

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3
Q

What Hernia has a sac?

A

True Hernia

Congenital Hernia

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4
Q

Congenital Hernia

A

Defect already present at birth but herniation may not occur until later

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5
Q

What are the types of Acquired Hernias?

A

Degenerative
Traumatic
Iatrogenic (surgery)

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6
Q

What are the locations of Abdominal Hernias?

A 
Paracostal
Dorsal lateral 
Inguinal 
Cranial pubic ligament 
Femoral 
Umbilical 
Ventral 
Scrotal
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7
Q

Reducible

A

Contents readily manipulated into cavity

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8
Q

Incarcerated

A

contents fixed into abnormal location

usually due to adhesions

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9
Q

Strangulated

A

incarceration obstructs vascular supply

usually surgical emergency

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10
Q

What are the principles of Herniorrhaphy?

A 
Ensure viability 
Return viable contents
Obliterate redundant tissue in the sac
Secure closure of defect 
Use patients own tissue when possible
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11
Q

What is the most common abdominal hernia?

A

Umbilical Hernia

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12
Q

What are the congenital defects associated with Umbilical Hernia?

A 
Cleft palate
Cryptorchidism 
Cranial abdominal hernia 
Incomplete sternal fusion 
Fucosidosis
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13
Q

What are the clinical signs of an Umbilical Hernia?

A

Soft round mass at umbilical scar
Often reducible
viscera is entrapped and becomes hard and painful

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14
Q

What is the treatment for Umbilical Hernia?

A

Conservative treatment for small or large hernias - Repair during elective surgery

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15
Q

Direct Inguinal Hernia

A

Hernia passes through vaginal process

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16
Q

Direct Inguinal Hernia

A

Hernia passes through inguinal musculature

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17
Q

What is the most common form of Inguinal Hernias?

A

Indirect form

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18
Q

Which Inguinal Hernia is less likely to become incarcerated?

A

Direct Inguinal Hernia

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19
Q

Congenital Inguinal Hernia

A

More common in males less than 2 years old due to a delayed inguinal ring narrowing from late testicular descent

20
Q

Acquired Inguinal Hernia

A

Common in middle aged overweight intact females due to a shorter or longer inguinal canal and associated with estrogen/estrus

21
Q

What are the clinical signs of Inguinal Hernia?

A

Painless unilateral or bilateral mass in inguinal area

Unilateral more on the left

22
Q

Describe Traditional Inguinal Hernia Repair

A
  1. Incision over lateral aspect of swelling
  2. Extend ring if cannot reduce contents
  3. Close ring
23
Q

What is the cause of Scrotal Hernia?

A

Weakness of vaginal orifice

24
Q

What causes Traumatic Abdominal Hernias?

A

Hit By Car

25
Q

Clinical signs of Traumatic Abdominal Hernia

A

Bulging mass
Asymmetric abdomen
Reducible contents
Palpable ring

26
Q

What patterns should you use for Acute Abdominal Hernia Repair?

A

Cruciate
Horizontal mattress
Vertical Mattress

27
Q

Describe Prepubic Tendon Rupture Repair

A

Place the patient with Truncal flexion with rear legs forward
Drill holes in the pubis
Place Synthetic mesh

28
Q

What suture should you use for Prepubic Tendon Rupture Repair?

A

Monofilament non-absorbable suture

29
Q

What are predisposing factors for Incisional Hernias?

A 
Intra-abdominal pressure: Obesity, Effusions, or pregnancy 
Entrapped fat
Inappropriate suture 
Infection 
Steroids delay healing 
Post op care
30
Q

When would you place an interrupted suture pattern in the closure of an Incisional Hernia?

A

pregnant

immunocompromised

31
Q

How do you tell the difference between a seroma and a hernia?

A

Seroma will not reduce

Hernia will reduce

32
Q

Perineal Hernia

A

Weakness and separation of the pelvic diaphragm

33
Q

What are the types of perineal hernias?

A

Lateral
Dorsal
Caudal
Ventral

34
Q

What is the most common perineal hernia?

A

Caudal

35
Q

What are the predisposing factors for perineal hernia?

A

Hormonal influence from intact male
Relaxin secreted in patients with prostatic disease
Neurogenic atrophy from straining

36
Q

Clinical signs of Perineal Hernia

A

Perineal swelling
Tenesmus
Constipation
Firm non-reducible painful mass

37
Q

How do you diagnose Perineal Hernia?

A

Rectal Palpation
Radiographs
US

38
Q

Medical Management for Perineal Hernia

A

Stool softeners
Periodic fecal evaluation
High fiber/high moisture diets

39
Q

When does Perineal Hernia become an emergency?

A

Irreducible painful discolored swelling
Bladder retroflexion
Urethral obstruction
Azotemia

40
Q

What are the surgical options for Perineal Hernia Repair?

A 
Traditional Herniorrhaphy 
Internal obturator muscle transposition 
Superficial gluteal muscle transposition 
Semitendinosus muscle transposition 
Prosthetic implants
41
Q

What do you preform if the surgery for Perineal Hernia Repair fails?

A

Colopexy
Cystopexy
Ductus deferopexy

42
Q

What is the post op care for Perineal Hernia surgery?

A

4-6 weeks of stool softeners

Pain Management

43
Q

What are the complications associated with Perineal Hernia Repair?

A 
Infection/Abscess
Fecal Incontinence
Sciatic injury 
Urinary dysfunction 
Tenesmus
44
Q

What effects the prognosis for Perineal Hernia Repair?

A 
Surgeons experience 
Previous repairs
Suture type 
Poor local tissue strength 
Amount of tension 
Castration
45
Q

What are the predisposing factors for Feline Perineal Hernia?

A

Megacolon
Perineal masses
Colitis

RUSVM Small Animal Surgery 2017 (17 decks)

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