Umbilical surgery Flashcards
What do the umbilical artery, vein + urachus become?
*Umbilical artery = round ligament of the bladder
*Umbilical vein = round ligament of the liver
*Urachus = scar on bladder
How would you diagnose umbilical problem?
*History - urination?
*Clinical exam - infection, suck reflex, joint ill, lungs, CNS
What can palpation tell you?
*Reducible into abdomen without pain = simple hernia
*Partially reducible = hernia + abscess
*Irreducible = abscess, complicated hernia
How can you identify discharging tracks?
*Use urinary bitch catheter - blunt probe
*Ultrasound
What are other investigations that occur?
*Total proteins - see if failure of passive transfer
*Fibrinogen = chronic inflammation
*White cell count = active inflammation = peritonitis?
What is the major cause of simple hernia?
*Genetic
*More likely to herniate if infected
How do you treat simple hernias?
*If less than 1cm diameter leave
*Larger = surgery = Vicryl
*House with smaller animals = avoid bullying
How is surgery of a hernia carried out?
*Anaesthetic = xylazine + local (procaine) = cranial to umbilicus
*Dissect down edges of hernial ring to free peritoneum
*Hernia back into abdomen - don’t open sac
*Stitch with mayo overlapping (Vest over pants)
What is likely aetiology of umbilical infection outside body wall?
*A. pyogenes / E.coli
*Tx = antibiotics - amoxicillin
What should be done to treat patent / infected urachus?
*Flush + antibiotics
How would you treat infected umbilical VEIN?
*Partial hepatectomy - poor prognosis
What are complications of umbilical hernias?
*Seroma
*Re-herniation
*Infection
What umbilical infection has the worst prognosis + why?
*Infected umbilical vein = may have liver involvement
