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10- SA- Abdominal, Oral and Rectal Disease > Hernias and ruptures > Flashcards

Hernias and ruptures Flashcards

1
Q

define hernia

A

A protrusion of an organ or part of an organ through a defect in the wall of the anatomical area in which it normally lies.

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2
Q

define prolapse

A

A prolapse is the movement of an organ or tissue out of its normal anatomical location, without passing through a deficit in the body wall, often occurring under the influence of significant force

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3
Q

what are the aims of hernia surgery

A

Return hernia content to normal location
Secure closure of neck of sac
Obliterate redundant tissue in the sac
Try to use the patient’s own tissues for repair

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4
Q

describe how to diagnose umbilical hernia

A

palpation

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5
Q

describe how to treat umbilical hernia

A
  • Can resolve spontaneously, or be corrected at neutering
    Repair by reducing, incise over hernia, excise sac and repair muscle edges
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6
Q

what do we tend to close hernia repairs with

A

synthetic, absorbable monofilament

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7
Q

what can you see if hernia is strangulated

A

vomiting/abdominal pain

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8
Q

when do incisional hernias occur

A

Surgical closure of body cavity fails
Generally linea alba
Normally within 7 days
Can be chronic

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9
Q

describe how to investigate incisional hernias

A

palapation
radiography or US

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10
Q

describe how to treat incisional hernia

A

repair ASAP
Lavage and resect nonviable
Re-open and repair entire wound
Suture EXTERNAL SHEATH OF RECTUS ABDOMINIS (strongest holding layer)
Ensure monofilament suture, long lasting and appropriate size

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11
Q

describe how to treat traumatic abdominal rupture

A

same as hernia
Identify free edge of abdominal wall and reattach to cranial pelvic brim if prepubic tendon rupture
Prognosis relates to organs involved

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12
Q

what can happen in inguinal hernia

A

Intestine, bladder or uterus can enter subcutaneous space (in the groin)

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13
Q

what is inguinal hernias associated with

A

obesity and pregnancy
though to be inherited

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14
Q

why should you not castrate guinea pig with open method

A

have large inguinal rings
increases chance of scrotal hernia

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15
Q

describe how diaphragmatic ruptures present

A

generally after trauma
* Pale/cyanotic
* Tachypnoeic/dyspnoeic
* Tachycardic
* Occasional cardiac arrythmias
* Hydrothorax

often incidental finding

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16
Q

how do diaphragmatic ruptures occur

A

Tear in diaphragm allows abdominal content to move into thorax

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17
Q

what do you see on radiography with diaphragmatic rupture

A

○ Loss of diaphragmatic line
○ Loss of cardiac silhouette
○ Presence of gas filled structure in thorax
○ Atelectasis
○ Displaced abdominal organs

18
Q

Describe how to treat diaphragmatic rupture

A

Stabilise first- O2, IVFT and warm up
Prophylactic antibiotics due to toxin release from organ strangulation
ECG
Only do surgery ASAP- Acute gastric distension- if not do after 24hr

19
Q

which breeds are more likely to get hiatal hernias

A

Brachycephalic breeds (English bulldog, French bulldog, pug, etc.), Shar pei

20
Q

what do you see with hiatal hernias

A

Clinically very similar to oesophagitis
○ Regurgitation
○ Hypersalivation
○ Visceral discomfort
Normally thin

21
Q

describe how to diagnose hiatal hernias

A

radiography- soft tissue opacity in dorso-caudal thorax adjacent to diaphragm
Fluoroscopy
Endoscopy

22
Q

Describe how to treat hiatal hernias

A

Antacid
Sucralfate
Prokinetic
Antibiotic (if aspiration)

+ surgery

23
Q

what is a Peritoneopericardial diaphragmatic hernia (PPDH)

A

Congenital communication between pericardial sac and abdomen
Faulty development of septum transversum

24
Q

List the clinical signs seen with PPDH

A

GI or respiratory signs e.g. v+/d+, anorexia weight loss, wheezing, dyspnoea

25
Q

which breeds tend to be effected by PPDH

A

weimaraner
cocker spaniel

26
Q

describe what you see on radiography with PPDH

A

enlarged cardiac silhouette
dorsally displaced trachea
gas opacities in pericardial sac

27
Q

what surgery is used to fix PPDH

A

Ventral midline coeliotomy
Incise sternum if necessary
Reduce viscera
Suture diaphragm - no need to seperatley close the pericardium

28
Q

What is the difference between a rupture and a hernia

A

rupture normally has no ring or sac

29
Q

what are the principles of defect closure of a hernia

A

-Direct opposition if possible
-Use holding later
-Dont tighten too much to compromise vasculature
-Use strong monofilament suture (PDS)
-Eliminate dead space

30
Q

How are defects that are too big to be closed by direct oppositon closed?

A

-Muscle flap
-Polypropylene mesh
-Omentum

31
Q

what are the clinical signs of an umbilical hernia

A

Soft painless swelling at umbilicus
V+ and abdominal pain if strangulation of bowel

32
Q

What can umbilical hernias contain

A

Usually fat or omentum
Occasionally intestine

33
Q

What are the predisposing factors to incisional hernias

A

Surgeon
Incorrect surgical technique
Incorrect suture/pattern
Entrapped fat between wound edges
Infection
Steroid therapy/cushings patient
Poor post op care

34
Q

what is the holding layer in linea alba closure

A

external rectus sheath

35
Q

what are traumatic abdominal ruptures commonly caused by

A

blunt trauma
bite

36
Q

What is the typical signalment for non traumatic inguinal hernias

A

-Intact female middle aged dogs
-<2yr male dogs
-Small breeds

37
Q

What types of tears of the diaphragm can result in diaphreagmatic hernia?

A

radial
circumferential

38
Q

What do you have to ensure takes place when performing diaphragmatic rupture surgery?

A

IPPV- open chest surgery

39
Q

List the clinical signs of a chronic diaphragmatic rupture

A

exercise intolerance
dyspnoea
vomiting
weight loss

40
Q

How is hiatal hernia treated surgically

A

-Ventral midline coeliotomy
-Reduce hernia a oesophageal hiatus and close
-Pexy oesophagus to diaphragm
-Pexy stomach to body wall

41
Q

describe a reducible hernia

A

is a hernia in which the contents of the hernial sac can be returned to their normal position

42
Q

describe a non-reducible hernia

A

ring has closed behind the herniated tissue and it can not be easily replaced

10- SA- Abdominal, Oral and Rectal Disease (19 decks)

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