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Flashcards in SA Hernias Deck (28)
1

Give an example of a congenital and acquired hernia

Congenital: umbilical
Acquired: diaphragmatic

2

What is the definition of a reducible, incarcerated and strangulated hernia?

Reducible: can go back into body cavity
Incarcerated: contents of hernia are trapped in hernia
Strangulated: contents are trapped, blood supply is cut off

3

Give some clinical signs of herniation involving the GI tract

Vomiting
Abdominal pain
Toxaemia
Shock

4

Give some clinical signs of herniation involving the bladder/urethra

Dysuria (painful urination)
Abdominal pain
Vomiting
Toxaemia
Shock

5

Which suture material could you use to suture fascia when repairing a hernia and why?

Choose a permanent or slowly absorbed monofilament material eg nylon, PDS, as fascia is slow to heal

6

What is PPDH?

Pericardio-peritoneal diaphragmatic hernia

7

Why are male animals more predisposed to congenital caudal abdominal hernias?

Due to delayed inguinal ring closure associated with testicular descent

8

Why are female animals more predisposed to acquired caudal abdominal hernias?

Effects of oestrogen?
Inguinal canal is wider and has a greater diameter in females

9

How would you diagnose an inguinal hernia from other differential diagnoses eg abscess/lipoma?

Radiography (altered location of abdominal organs, loss of detail of caudal abdominal strip/flank musculature)
Contrast radiography
Ultrasound

10

What passes through the inguinal canal in the male and female?

Female: external pudendal artery and vein. Genitofemoral nerve. (Also caudal superficial epigastric artery and vein)
Male: same, plus spermatic cord

11

How would you perform an uncomplicated hernial repair?

Incise over lateral aspect of swelling
Blunt dissect to expose hernial sac
Reduce hernial contents
Ligate neck of sac close to inguinal ring and amputate
Reduce inguinal ring by suturing

12

Give some post-operative complications following hernial repair surgery

Usual postoperative wound complications plus:
Pain
Haematoma
Seroma
Recurrence

13

How do scrotal hernias occur?

Rare
Defect in vaginal ring allows abdominal contents to protrude into vaginal process beside spermatic cord

14

Give some clinical signs of scrotal hernias

Pain
Swelling
Organ dysfunction

15

Which nerves innervate the levator ani (part of pelvic diaphragm)?

Direct branches of sacral plexus (S3-S5), some innervation from pudendal nerve also

16

What is a perineal hernia?

Failure of muscular pelvic diaphragm to support rectal wall which stretches and deviates
Pelvic and/or abdominal contents protrude between rectum and pelvic diaphragm

17

In which sex are perineal hernias more common and why?

Male entire older dogs, rare in cats and bitches
Due to muscle atrophy (levator ani and coccygeus), hormones, myopathies, prostatic diseases?

18

Give some clinical signs of perineal hernias

Reducible perineal swelling (ventrolateral to anus; disappears when animal defecates)
Constipation/obstipation (severe/complete constipation)
Defecatory/urinary tenesmus
Dysuria (excess straining can push bladder into hernia -> urethral obstruction)

19

What may you find in a perineal hernia?

Prostate
Bladder
Omentum
Small intestines

20

How would you diagnose a perineal hernia?

Rectal examination
Routine haematology/biochemistry and electrolytes (esp if dysuric)
Radiography
Ultrasound

21

Give some post-op complications following perineal hernia surgery

Rectal prolapse
Wound infection
Continued defecatory tenesmus
Faecal incontinence
Atonic bladder following urethral obstruction/bladder retroflexion
Recurrence

22

Where would you incise when doing a surgical repair on a diaphragmatic hernia/rupture?

Midline cranial coeliotomy (from umbilicus to xiphoid process -caudal sternum)

23

Why may an incisional hernia occur weeks to years after surgery?

Obesity
Hypoproteinemia
Chronic steroid treatment
Deep fascial infection
Abdominal distension

24

Why may an incisional hernia occur within 7 days of surgery?

Increased abdominal pressure (eg vigorous activity)
Infection
Chronic steroid treatment
Technical error during wound closure (inappropriate suture choice/placement, entrapment of fat between wound edges)
Poor postoperative care

25

Give some clinical signs of an incisional hernia

Swelling
Oedema/inflammation
Serosanguinous wound discharge
Evisceration

26

What should you do if evisceration occurs following wound breakdown and incisional hernia?

Cover exposed organs with sterile bandage
Elizabethan collar, monitor
Pre-op analgesia, antibiotics, fluid therapy prior to induction
Lavage exposed tissues with large volumes of sterile saline
Open original wound, resect damaged tissues, lavage, close abdomen, drainage?

27

Define a hernia

The protrusion of an organ/part of an organ through a defect in the wall of the anatomical cavity in which it lies

28

What are the 3 parts of a hernia?

Ring: defect in body wall
Sac: tissue covering the herniated contents
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