Hernias

Question 1

what is a hernia

Answer 1

any full thickness defect or weakness in the abdominal wall that may allow protrusion of abdominal contents

Question 2

what is a true defect

Answer 2

may be within true aperture in the body - mesothelial membrane covering the contents

Question 3

What is a false defect

Answer 3

made by blunt trauma - no sac present

Question 4

what is an acquired defect

Answer 4

iatrogenic trauma (traunatic hernia

Question 5

what are the common hernias

Answer 5

cranial ventral midline hernia (umbilical, substernaL (ventral) 
Lateral hernias (paracostala, dorsal lateral hernia) 
caudal hernias (congenital scrotal, inguinal hernias) 
traumatic hernias (prepubic, femoral)

Question 6

what does the linea alba cover

Answer 6

converse the external abdominal oblique, internal abdominal oblique and tranverse abdominal muscles

Question 7

define incarceration

Answer 7

luminal obstruction of hollow organs

usually with small, inelastic hernial rings

Question 8

define strangulation

Answer 8

Herniated contents are incarcerated and undergoing devitalisation
ealry venous obstruction = reversible
arterial = irreversible

Question 9

what are the four aims of hernia repair

Answer 9

1. return contents (ensure viability)
2. close ring to prevent recurrence
3. obliterqate rebudnant tissue
4. use patients own tissue (if poss)

Question 10

in surgery when would you approach a hernia over the hernia ring

Answer 10

if uncomplicated and no evidence of obstruction or strangulation

Question 11

what are the 4 aims of a hernia repair

Answer 11

return content
close ring to prevent recurrence
obliterate redundant tissue
use patients own tissue if possible (tension free and secure primary closure of defect)

Question 12

what is the aetiology of ventral hernias

Answer 12

Congenital -failure of fusion or delayed fusion of lateral fold of the umbilicus

Question 13

define Omphalocoeles

Answer 13

Type of ventral abdominal
Large midline umbilical and skin defects ==>organs protrude in a transparent sac (aminotic tissue) - difficult to repair to much tension usually die

Question 14

what are the CS of Ventral abdominal hernias

Answer 14

Soft round mass or swelling at umbilical scar

Question 15

How do you treat ventral abdominal hernias

Answer 15

< 2-3mm treat conservatively = spontaneous closure can occur < 6 months of age
Neuter patient if genetic predisposition in in females de-sexing should correct it
surgically repair if size of finger/intestine

Question 16

define an indirect caudal abdominal hernia

Answer 16

Visceral enter cavity of vaginal process

- Usually cause organ dysfuntion due to narrowing of vaginal process at the inelastic inguinal ring

Question 17

what are the 3 presenting groups caudal abdominal hernias

Answer 17

young dogs
Mature dogs
Traumatic

Question 18

what are the two types of caudal abdominal hernias

Answer 18

Inguinal & Scrotal

Question 19

what is the surgical approach to an scrotal hernia

Answer 19

Emergency
Castration strongly recommended as recurrence rate high if not performed
Laparotomy if strangulated contents

Question 20

what is the surgical approach to an inguinal hernia

Answer 20

Hernial sac is exposed and hernial sac is ligated as close to the internal inguinal ring as possible and sac is amputated

Question 21

Femoral hernias

Answer 21

Rarre, protrusion of fat or abdominal contents through a defect in the femoral canal

Question 22

what are the two causes of femoral hernias

Answer 22

Iatrogenic femoral hernias due to transection of origin of pectineus muscles
Blunt trauma