Inguinal & Umbilical Hernias Flashcards
On which side do we more commonly see inguinal hernias in bulls?
Left
An indirect inguinal hernia:
- Involves bowel passing through the internal longitudinal ring
- Involves bowel passing through a rent in the body wall adjacent to the internal inguinal ring
- Can occur only in mares and geldings
- Rarely produces testicular compromise in the adult stallion
involves bowel passing through the internal longitudinal ring
If there is an umbilical vein infection extending to and involving the ________, the vein should be marsupialized to the ventral body wall
liver
- If there is an umbilical vein infection extending to and involving the liver, the vein should be marsupialized to the ventral body wall.*
- After surgery, the marsupialized tract is irrigated with iodine until closure by second intention*
T/F: Inguinal hernias in adult horses are usually acquired and non-reducible
True
- Inguinal hernias in the adult horses are usually acquired and non reducible
- Congenital inguinal hernias in foals are reducible
What is the difference between a direct and an indirect inguinal hernia?
- Direct goes through a defect in the abdominal wall
-
Indirect goes through a hole that already exists
- Indirect is more common
This healthy 2-month old calf is presented to your clinic. What is the most likely diagnosis?
simple umbilical hernia
Umbilical hernias are most commonly seen in ________ calves
Holstein
As part of the castration technique for inguinal hernias, a transfixation ligature is placed through the __________ muscle
cremaster
When is a mesh implant indicated for repair of umbilical hernia?
Hernia >15 cm and hernia unsuccessfully repaired previously
Polypropylene or plastic mesh are more commonly used in large animal
What portions of the intestine are most commonly found in an inguinal hernia?
jejunum and ileum
Equine patients with acquired inguinal hernias have a reported survival rate of ~___%
75%
What is the best method to examine the contents of an inguinal hernia?
Ultrasound
T/F: Any hernia with evidence of pathology should be surgically repaired with an open herniorrhaphy
True
In adult equine patients, are inguinal hernias usually congenital or acquired? Reducible or non-reducible?
Acquired, non-reducible
What are the benefits of an open herniorrhaphy for repair of an umbilical hernia?
- Takes less time
- Less traumatic
- Allows inspection of the viscera
- Permits removal of the umbilical remnants
Are inguinal hernias more commonly seen in males or females?
Males
Way more common in males
What is your diagnosis in this pig?
left inguinal (scrotal) hernia
T/F: Direct inguinal hernias are more common than indirect inguinal hernias
False
Direct inguinal hernias are very rare.
T/F: Bulls can maintain reproductive function following unilateral castration
True
- ~75% of sperm production remains*
- Unilateral castration can be used for inguinal hernia, orchitis, testicular torsion, testicular hematoma, and testicular tumor*
T/F: Calves have a higher prevalence of umbilical infection compared to foals
True
T/F: Scrotal hernias may damage thermoregulation leading to primary and secondary defects
True
__________ is the second most common type of hernia observed in large animals
inguinal hernia
- Congenital or acquired, unilateral or bilateral
- Congenital hernias more common in colts
- Appear in the first days of life
What is the “Vest Over Pants” suture?
overlapping interrupted mattress suture pattern
- “Vest Over Pants” is also known as mayo mattress, overlapping pattern, or vertical mayo pattern, but we all know “Vest Over Pants” is way more fun.
- It is an overlapping interrupted mattress suture pattern and is useful in repair of abdominal hernia defects and cleft palate
-
How is it done?
- The suture is begun by passing the needle from the outside to the inside of the incision on one side
- The needle is then similarly inserted on the opposite side on the same transverse plane in the same inward direction
- It is advanced 0.7 to 1.5cm and is passed from within to the outside on the second sutured side
- Finally, it is returned to the original side and is passed from within to the exterior in the same transverse plane
- As the knot is tied, the first area of tissue sutured will overlap the second
- A surgeon’s knot may be required to overcome distracting forces
- Sufficient sutures are placed to close the incision or defect
What equine breeds are most predisposed to developing inguinal hernia?
- Standardbred
- Draft breeds
- Morgan
T/F: The umbilical vein is the most commonly infected umbilical remnant
False
The urachus is the most commonly infected umbilical remnant. It is rare to see infection in the umbilical vein
Infection of the umbilical arteries is termed:
omphaloarteritis
When is conservative treatment of umbilical hernias appropriate?
If reducible (less than 3 fingers and less than 1 year of age)
What would be your treatment in this case of inguinal hernia?
- Keep vaginal tunic intact
- Twist the testicle to return the intestine back into the abdomen
- Place a transfixation ligature (through the cremaster muscle) just distal to the inguinal ring
- Ligate spermatic cord
__________ is the most common type of hernia observed in large animals
umbilical hernia
- Most commonly affect females
- Quarter horses and Holstein cattle predisposed
- Contains intestine, omentum, or abomasum
What are the selection criteria for the castration technique using injectable anesthesia for inguinal hernias?
- Hernia is manually reducible
- No edema or erythema
- No colic
You observe this presentation in a bull and you diagnose inguinal hernia. What procedure would you recommend to the owner?
inguinal herniorrhaphy
T/F: Congenital inguinal hernias in foals may resolve if manually reduced twice daily
True
The “Vest Over Pants” suture pattern is useful for repairing umbilical hernias and __________
cleft palate
-
“Vest Over Pants” is also known as mayo mattress, overlapping pattern, or vertical mayo pattern, but we all know “Vest Over Pants” is way more fun.
- It is an overlapping interrupted mattress suture pattern and is useful in repair of abdominal hernia defects in all domestic mammals
Identify this piece of equipment:
hernia clamp
Is infection of umbilical remnant more common in foals or calves?
more common in calves
- In a calf, it is more common to do an open herniorrhapy because inflammation of the umbilical remnant is more common, so peritoneum must be opened to get in there all nice and deep like and get it cleaned out*
- In a foal, closed herniorrhapy is more common*
T/F: Visual evaluation is one of the most useful tools in distinguishing umbilical abscess from umbilical hernia
False
Visual evaluation is probably one of the worst tools for distinguishing umbilical abscess from umbilical hernia
T/F: Calves have a lower prevalence of umbilical infection compared to foals
False
Calves have a higher prevalence of umbilical infection compared to foals
T/F: Inguinal hernias are more common in females. Umbilical hernias are more common in males.
False
Inguinal hernias are more common in males. Umbilical hernias are more common in females.
