Flashcards in SA Hernias Deck (28)
Give an example of a congenital and acquired hernia
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
Give some clinical signs of herniation involving the GI tract
Give some clinical signs of herniation involving the bladder/urethra
Dysuria (painful urination)
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
What is PPDH?
Pericardio-peritoneal diaphragmatic hernia
Why are male animals more predisposed to congenital caudal abdominal hernias?
Due to delayed inguinal ring closure associated with testicular descent
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
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)
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
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
Give some post-operative complications following hernial repair surgery
Usual postoperative wound complications plus:
How do scrotal hernias occur?
Defect in vaginal ring allows abdominal contents to protrude into vaginal process beside spermatic cord
Give some clinical signs of scrotal hernias
Which nerves innervate the levator ani (part of pelvic diaphragm)?
Direct branches of sacral plexus (S3-S5), some innervation from pudendal nerve also
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
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?
Give some clinical signs of perineal hernias
Reducible perineal swelling (ventrolateral to anus; disappears when animal defecates)
Constipation/obstipation (severe/complete constipation)
Dysuria (excess straining can push bladder into hernia -> urethral obstruction)
What may you find in a perineal hernia?
How would you diagnose a perineal hernia?
Routine haematology/biochemistry and electrolytes (esp if dysuric)
Give some post-op complications following perineal hernia surgery
Continued defecatory tenesmus
Atonic bladder following urethral obstruction/bladder retroflexion
Where would you incise when doing a surgical repair on a diaphragmatic hernia/rupture?
Midline cranial coeliotomy (from umbilicus to xiphoid process -caudal sternum)
Why may an incisional hernia occur weeks to years after surgery?
Chronic steroid treatment
Deep fascial infection
Why may an incisional hernia occur within 7 days of surgery?
Increased abdominal pressure (eg vigorous activity)
Chronic steroid treatment
Technical error during wound closure (inappropriate suture choice/placement, entrapment of fat between wound edges)
Poor postoperative care
Give some clinical signs of an incisional hernia
Serosanguinous wound discharge
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?
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