the power point presentation is full of illustrations and pictures

1. Ventral abdominal hernia
• Other than natural
orifice(umblicus/
inguinal
• Described – false
hernia- not through
body openings)
• Ventral to stifle skinfold-
ventral hernia/ rest
lateral hernia

3. Causes/Usually aquired- trauma
Kicks
and falls
Abdominal
trauma accidents
straining
Post operative

4. • Common location –
flank near pelvis

5. • If no peritoneum in sac- adhesions are more
• Left flank- mostly rumen(harmless and surgery
not done)
• Signs:
• Assymetry/ swelling
• Systemic complication

6. Diagnosis
• Palpation
• Radiography
• Discontinuity of ‘flank stripe’ (disturbed
outline of flank)
• Contrast radiography

7. Treatment
• If fresh traumatic injury – delay the repair- if
inflammation present is too large
• Prolonged delay- complications
• As in umblical H.
• Linear incision- suture the layers as in
laparotomy wound

8. • From inside to outside
1.Peritoneum
2.Transverse abdominis(CC)
3.Internal oblique(cranio ventral)
4.External oblique(caudoventral)

9. Diaphragmatic hernia
• Abdominal viscera –
thoracic cavity –
through congenital/
aquired opening

10. • Contents –
reticulum, omasum,
abomasum, L.Animal
s
• S.animals-
spleen, liver, stomac
h, intestines

11. Incidence
• Buffaloes, females- rt. Side- one or multiple rings
• Dogs – equal on both sides
• Etiology: weak diaphragm
• TRP/ FB
• Increased intraabdominal pressure
• Musculotendineous junction(less tone and thickness)

12. Weakest spots of rupture
• Hiatus post.aorta
• Hiatus post. Vena cava
• Hiatus osophagi
• Weak points
1. Rt.of esophagus
2. Anywhere in central border
3. Close to post. Aorta
4. Above post.vena cava

13. Diagnosis
• Signs: SA severe dyspnoea- abducted elbows
• Depends on structures herniated and size of tear
• Signs of obstruction, gastric dilatation, liver problems
(vomiting anorexia, jaundice, exercise intolerance)
• Signs of pneumothorax, lung contusion

14. • Auscultation: intestinal sounds on thoracic
cage is heard
• Muffled heart sound
• History of recent parturition
• Large animals:

15. • Recurrent tympany (inresponsive to medical
treatment)
• Signs are mild to severe (small reticular portion or
includes reticuloomasal opening)
• Adhesions of reticulum with diaphragm and
distortion of reticuloomasal opening- reduce
reticular motility
• Less milk yield
•

16. • scant defecation/diarhoea with foul smell
• Aspiration pnemonia in advanced cases
• Brisket edema
• Jugular pulsation
• Abduction of limbs
• Coughing may be present

17. Auscultation
• Muffled heart sounds
• Reticular sounds cranial to 6th rib
• Radiography:
• Lateral/DV
• Plain/contrast
• Plain:empty reticulum as air filled viscus in
thoracic cavity
• Absence of normal diaphragmatic line

18. • Radiopaque organs-
liver/spleen – displacing
normal thoracic viscera
• If hydrothorax present-
pleural effusions –drain
the fluid and go for RG

19. Comparison

20. • Radiopaque organs-
liver/spleen – displacing
normal thoracic viscera
• If hydrothorax present-
pleural effusions –drain
the fluid and go for RG

21. • Presence of gas filled
structures in
thorax(stomach/
intestines)

22. • Contrast RG
Confirmatory
- Barium meal
- Cholecystography- aid
in diagnosis of liver
herniation

23. Treatment
• Laprorumenotomy:
• Evacuate rumen 3/4th or full
• Replace with healthy liquor
• Off feed 48 hrs after evacuation-fluid therapy
• GA- 6% chloral hydrate(30-60mg/kg)-15/20 min.-
thiopental sodium till effect
• 6% chloral hydrate(50-60mg/kg)-15/20 min.-
diazepam (0.3-0.5mg/kg)
• IPPV after intubation

24. • Approaches:
• Transabdominal
• Transthoracic

25. • Transabdominal: pict
• Rt. Cranial quadrant/
Hypochondriac area
prepared for surgery

26. • 25-30 cm incision: 5
cm caudal to xiphoid
cartilage: parallel to
costal arch

27. • sever the adhesions
of diaphragm and
reticulum
• abdominal and
thoracic organs

28. • close- ring-
continuous lock-
stitch suture – non-
absorbable- close
the abdominal
incision

29. • M.and peritoneum by
series of interrupted
mattress

30. • Transthoracic
• rt./ left lat.
Thoracotomy
• midway on 7th rib-
25cm- downwards
towards costochondral
junction

32. • rib resection
• incise pleura- herniated
reticulum seen
• separate the adhesions
with lungs and pleura
• push in abd. Cavity

33. • close the d. rent
• resect indurated diaphragmatic tissue along
with reticulum- adhesions are extensive
• if small gap- close by few sutures
• if large – use grafts

34. • Similarly, adhesions with pulmonary lobe
requires partial/complete lobectomy
• It may recur, if animal is pregnant at the time
of surgery- after parturition – so postpone
surgery till after parturition- rumen fistula –
partial relief

35. • dogs:
• ventral abdominal approach is preferred since
access to both sides of diaphragm – ventral
midline behind the xiphoid cartilage
• if necessary prolong the cranial abdomen
incision by splitting the sternum cranially

36. • lateral thoracotomy if a long standing hernia
involving parenchymatous organ
• handle liver carefully as it may bleed/ rupture
the liver peritoneum

37. • if on ventral aspect of dia. And in contact with
pericardium – median sternotomy
• edge of tear is not scarified – even if
longstanding- suture the rent – simple
interrupted / horizontal mattress suture / 0/
2-0 silk / chromic catgut

38. • prognosis is good in small animals
• hiatal hernia – caudal end of esophagus and
cardia area of stomach passes through hiatus
esophagi of diaphragm

39. Inguinal and scrotal hernia
• Inguinal h. : protrusion of an organ through
the inguinal canal (bubonocele)

40. • If upto the scrotum
(oscheocele/ scrotal h.)

41. Congenital / Aquired
• Inguinal/ Scrotal : congenital:
• Rare in cattle and rams :
• Common in pigs (cryptorchid) and
• Horses(next to pigs)

42. • Common in bitches esp. the preg. ones (inguinal
hysterocele)-obesity

44. • increased intraabdominal pressure (rough
mounting of animals)
• contents are omentum , intestine or both and
rarely the UB
• inguinal canal: 2 rings
• deep inguinal ring
• superficial inguinal ring
• bet. These two rings – inguinal canal

45. • vaginal ring : near the deep
inguinal ring above that or
dorsal to deep inguinal ring
– vaginal ring(males)
• VR is nothing but opening of
the lumen of the vaginal
tunic into the abdominal
cavity.

46. • Vaginal ring is ring of the
peritoneum formed by
vaginal tunic as it passes
through internal inguinal ring
• It is not circular- slit like

47. • Deep inguinal ring
Medial wall –
internal oblique and
lateral wall is made
by inguinal ligament
• Superficial inguinal
ring- opening in -
pelvic tendon of
external oblique m.

48. • deep inguinal ring:
• bounded
ventrocranially by
caudal edge of the
internal oblique
abdominal muscle and
dorsocaudally by the
inguinal ligament

49. superficial inguinal ring : slit like
opening in the external oblique
abdominal tendon

51. • males this canal acts as a
passage for structures like
spermatic cord within the
common vaginal tunic
• in male, passes caudally
on each side to the
scrotum ending with the
testis

52. • In females vaginal tunics extend upto the vulva
and there is no vaginal ring
• In horses : the 2 inguinal rings do not overlie
each other. In pig both rings overlie each other
and canal is virtually non existent
• Ruminants – canal is shorter than in horses

53. Confusions
• The vaginal ring should
not be confused with
deep inguinal
ring(inguinal rings are
present in both males
and females but vaginal
ring is present only in
males)

54. • Using of term inguinal
canal as though it is
same as spermatic sac
where as the canal is
occupied more than the
spermatic sac

55. • Area bet. the
superficial inguinal
ring and neck of
scrotum is
sometimes spoken of
as being part of
inguinal canal but
the external limit of
inguinal canal is the
superficial ring

56. • There is lot of gap
anatomically present
between the neck of
scrotum and superficial
inguinal ring.
• So it is difficult to
describe the hernia- bet.
Superficial ring and neck
of the scrotum

57. • Decided to name the h. on the basis of neck of
hernia
• If neck is inguinal ring- inguinal
• If neck is inguinal ring+neck of scrotum-
scrotal hernia