Hernias

Question 1

What are the five different anatomical hernia sites?

Answer 1

Umbilical
Ventral midline
Lateral abdominal
Diaphragmatic
Caudal abdominal

Question 2

What are the three categories of hernias?

Answer 2

Reducible
Incarcerated
Strangulated

Question 3

What are the three anatomical hernia positions?

Answer 3

Ring
Sac
Contents

Question 4

What is a true hernia?

Answer 4

Opening through a normal aperture

AKA indirect hernia

Question 5

What is a false hernia?

Answer 5

Doesn’t contain a complete peritoneal sac, usually created by trauma or after breakdown of surgical entry
AKA direct hernias

Question 6

What type of hernias are the most common equine hernias?

Answer 6

Usually they are true (indirect) hernias- pass through the vaginal ring into the vaginal tunic

Question 7

Inguinal hernia

Answer 7

Intestinal contents within the inguinal canal

Question 8

T/F: Unilateral congenital inguinal hernias are most common

Answer 8

TRUE

Question 9

T/F: Congenital inguinal hernias in equine typically spontaneously regress around 3-6 months of age?

Answer 9

TRUE

Question 10

When is a ruptured inguinal hernia seen?

Answer 10

4-48 hours after birth in foals

Question 11

T/F: Inguinal hernias in adult equine are typically non-reducible

Answer 11

True

These are reducible in foals

Question 12

What are some CS of a ruptured inguinal hernia?

Answer 12

Scrotal swelling
Testicle cool (vascular compromise)
Colicky stallion

Question 13

What is the most common type/content of a ruptured inguinal hernia?

Answer 13

Distal jejunum and ileum are the most common

Question 14

T/F: An inguinal rupture/non-reducible hernia is classified as an emergency surgery

Answer 14

TRUE

Question 15

What is the sx procedure for an inguinal hernia?

Answer 15

Laparoscopic herniorrhaphy

Question 16

What areas should be prepped when performing sx correction for an acquired inguinal hernia?

Answer 16

Inguinal region and ventral abdomen

Question 17

What is the most common side in cattle for an indirect inguinal hernia?

Answer 17

Left side due to the increased pressure from the rumen

Question 18

What breed of cattle more commonly has indirect inguinal hernias?

Answer 18

Beef breeds (Hereford)
Chronic problem in cattle

Question 19

How is an indirect inguinal hernia diagnosed in cattle?

Answer 19

Rectal palpation

Question 20

What is a classical characteristic of an indirect inguinal hernia in cattle?

Answer 20

Hourglass configuration

Question 21

T/F: Direct inguinal hernias in cattle are commonly due to trauma, have no side predilection, no hourglass appearance and is considered an emergency surgery

Answer 21

TRUE

Question 22

What is the most common type of hernia in the horse?

Answer 22

Umbilical hernia

Most of these are congenital

Question 23

When is it considered a “routine” umbilical hernia in equine?

Answer 23

When majority of foals with palpable defect at birth closes within 4 days

Question 24

How are umbilical hernias diagnosed?

Answer 24

Rectal palpation

Ultrasound

Question 25

What prognosis is expected from a thickened hernia ring?

Answer 25

Good prognosis for repair

Question 26

What prognosis is expected from a thin/indistinct hernia ring?

Answer 26

Potential increased complication

Question 27

What is the most common content in a umbilical hernia?

Answer 27

Ileum or small intestine

Question 28

T/F: Hernias <5cm diameter and reducible can be managed with conservative tx

Answer 28

TRUE

Question 29

When should sx treatment be considered for hernias?

Answer 29

Not spontaneously resolving by 4 months of age | Hernias>10 cm diameter

Question 30

Why should a hernia clamp not be used in foals?

Answer 30

Increases risk of infection and it is painful

Question 31

What is the preferred surgical treatment for an umbilical hernia?

Answer 31

Open herniorrhaphy

Question 32

What is the treatment of a strangulated umbilical hernia?

Answer 32

Celiotomy cranial to the ring followed by en bloc resection of lesion

Question 33

How long should a foal be confined to a box stall post herniorrhaphy?

Answer 33

30-45 days

Question 34

What are the five categories of umbilical hernias in calves?

Answer 34

``` Uncomplicated hernias Hernias with SQ infection/abscessation Hernias w/ infection of umbilical remnant Umbilical abscesses/chronic omphalitis Urachal cysts/ruptures ```

Question 35

What is the most common birth defect in cattle?

Answer 35

Uncomplicated umbilical hernia (hereditary)

Question 36

Which type of cattle are more predisposed to umbilical hernias?

Answer 36

Dairy cattle

Question 37

What does a hernial sac in cattle most commonly contain?

Answer 37

Abomasum

Question 38

When can conservative treatment of a hernia be done in cattle?

Answer 38

Only when <5cm Reducible No hx/evidence of infection

Question 39

When should surgical intervention be considered in cattle?

Answer 39

>5cm any pathologic evidence Open herniorrhaphy should be done

Question 40

What is the most frequently infected remnant post herniorrhaphy?

Answer 40

Urachus

Question 41

What is involved when omphalophlebitis extends cranially?

Answer 41

Liver