Umbilical swellings (Yr 3)

Question 1

what is a possible consequence of cranial umbilical swelling?

Answer 1

development of a liver abscess (leading to systemic inflammation… polyarthritis, endocarditis etc.)

Question 2

what are the vessels of the umbilicus?

Answer 2

umbilical artery
umbilical vein
urachus

Question 3

where does the umbilical arteries run to?

Answer 3

bladder

Question 4

where does the umbilical vein run to?

Answer 4

liver

Question 5

where does the urachus run to?

Answer 5

bladder

Question 6

what does the umbilical artery become?

Answer 6

round ligament of bladder

Question 7

what does the umbilical vein become?

Answer 7

round ligament of liver

Question 8

do calves have two umbilical arteries or two umbilical veins?

Answer 8

arteries (that run to the bladder)

Question 9

when palpating an umbilicus the swelling is reducible, what is the most likely cause?

Answer 9

simple hernia

Question 10

when palpating an umbilicus the swelling is partially reducible, what is the most likely cause?

Answer 10

hernia and abscess

Question 11

when palpating an umbilicus the swelling is irreducible, what is the most likely cause?

Answer 11

abscess
hernia with incarceration/stangulation/adhesions

Question 12

how should you identify tracts within the swelling?

Answer 12

ultrasound

Question 13

where will you follow the umbilical vein to on ultrasound?

Answer 13

liver

Question 14

where will you follow the urachus to on ultrasound?

Answer 14

bladder

Question 15

where will you follow the umbilical artery to on ultrasound?

Answer 15

bladder

Question 16

when would abdominocentesis be indicated?

Answer 16

swollen abdomen and signs suggesting peritonitis (run TP and cytology)

Question 17

what tests can be run on young calves with umbilical swelling?

Answer 17

plasma total protein or zinc sulphate to assess passive transfer
abdominocentesis (if signs of abdominal swelling or peritonitis)
differential white cell count

Question 18

is there a link between umbilical infection and hernia?

Answer 18

yes - more likely to have hernia if infected

Question 19

when is the best time to do umbilical surgery?

Answer 19

young (under 12 weeks) whilst hernia and animal is still small

Question 20

what should be done with very large holes during umbilical hernia surgery?

Answer 20

put in polypropylene (prolene) mesh

Question 21

what aftercare is needed after hernia surgery?

Answer 21

at least 1 month box rest (do not turn out within 3 months of surgery)

Question 22

where should you block locally before umbilical surgery?

Answer 22

in a V shape cranial to the umbilicus

Question 23

should you open the peritoneum during umbilical surgery?

Answer 23

no - keep it closed and finely dissect away from the body wall, unless tightly adhered

Question 24

what type of suture is used for hernias?

Answer 24

mayo overlapping (vest-over-pants)

Question 25

which side of the incision is the prolene mesh placed?

Answer 25

inside the incision at the side of the peritoneum

Question 26

what is the most common causes of umbilical infections?

Answer 26

E. coli
Trueperella pyogenes

Question 27

how can umbilical infections be treated?

Answer 27

antibiotics (amoxilcillin)
flush if open (saline)

Question 28

what treatment is needed for a patent urachus?

Answer 28

usually needs surgery
(can try flushing and antibiotics)

Question 29

what are some possible complications of umbilical surgery?

Answer 29

seroma
reherniation
infection (use absorbable suture)