Abdominal hernia as a rare manifestation of feline mammary gland carcinoma: a case report.

A 15-year-old, spayed female, Scottish Straight cat without any traumatic history was presented with swollen abdomen and diagnosed as an abdominal wall hernia. Abdominal ultrasound revealed thickened, irregular, and hypoechoic change of abdominal wall muscle adjacent to defect. During the herniorrhaphy, multiple nodules were identified in the subcutaneous tissue around the defect. Histological examination of the nodular tissue was performed, and it was confirmed as mammary gland tumor. After the surgery, metastatic changes of the pancreas were identified, and pleural effusion and ascites were also confirmed. The patient deteriorated rapidly and died 78 days after the surgery. This is the first case presenting abdominal wall hernia induced by malignant tumor in veterinary medicine.

Lateral abdominal hernia associated with thin abdominal musculature in a calf.

This study aimed to evaluate the clinical utility of ultrasonography in the diagnosis of a newborn calf presenting with extended swelling within its right flank, in addition to its therapeutic planning. Ultrasonograms of the bilateral flanks identified thinning of the external and internal oblique abdominal muscles in whole areas of the abdominal walls. A right lateral abdominal hernia associated with thin abdominal muscular structures was diagnosed ultrasonographically. The right flank abdominal hernia was successfully reconstructed through a modified Mayo mattress suture. This allowed the overlapping of the two very thin structures of the abdominal walls, resulting in the creation of a thicker structure of the right lateral abdominal walls. Reconstruction of the abdominal walls using this method could prevent re-protrusion of the viscera during calf growth.

Abdominal Hernia in Equine: Animal Level Risk Factors and Repair Using Polypropylene Mesh.

There is a paucity of information regarding the frequency and risk factors associated with the occurrence of an abdominal hernia in different equine species especially donkeys, and mules. In addition, the effectiveness of using polypropylene mesh for the surgical management of abdominal hernia in donkeys and mules is still unknown. The purpose of the present study was to evaluate the efficacy of using polypropylene mesh for the surgical treatment of abdominal hernia in horses, donkeys, and mules and to address the occurrence and risk factors associated with an abdominal hernia in the selected animal species. Based on clinical and ultrasound proof of abdominal hernia, 48 animals were included in the current study. A questionnaire was created to imply the assumed risk factors associated with occurence and clinical findings of abdominal hernia. Hernioplasty using polypropylene mesh was used for the surgical treatment. The abdominal hernia was prevalent (P < .05) in foals followed by adult horses, donkeys, and mules (25, 15, 6, and 2), respectively. Ages from 3 to 5 years exhibited more abdominal hernias in donkeys, mules, and horses (12.5%, 4.2%, and 31.3%, P < .05), respectively. In all studied animals, females were more prevalent than males (70.8%, n = 34 vs. 29.2%, n = 14) respectively. The complication of abdominal wall hernia was positively affected by the time to repair admitted cases (P = .000). The majority of the animals (36 cases) recovered without complications, however, 10 cases had mild difficulties such as suture abscess, wound infection, serous fluid accumulation, and hematoma postsurgery. In addition, two cases of postoperative recurrence were documented. The results herein indicated that polypropylene mesh hernioplasty may be an alternative to the treatment of equine abdominal hernia. Recognizing the potential risk factors associated with an abdominal hernia in different equine species may be helpful to construct the best preventive measures.

Genes and SNPs Involved with Scrotal and Umbilical Hernia in Pigs.

Hernia is one of the most common defects in pigs. The most prevalent are the scrotal (SH), inguinal (IH) and umbilical (UH) hernias. We compared the inguinal ring transcriptome of normal and SH-affected pigs with the umbilical ring transcriptome of normal and UH-affected pigs to discover genes and pathways involved with the development of both types of hernia. A total of 13,307 transcripts was expressed in the inguinal and 13,302 in the umbilical ring tissues with 94.91% of them present in both tissues. From those, 35 genes were differentially expressed in both groups, participating in 108 biological processes. A total of 67 polymorphisms was identified in the inguinal ring and 76 in the umbilical ring tissue, of which 11 and 14 were novel, respectively. A single nucleotide polymorphism (SNP) with deleterious function was identified in the integrin α M (ITGAM) gene. The microtubule associated protein 1 light chain 3 γ (MAP1LC3C), vitrin (VIT), aggrecan (ACAN), alkaline ceramidase 2 (ACER2), potassium calcium-activated channel subfamily M α 1 (KCNMA1) and synaptopodin 2 (SYNPO2) genes are highlighted as candidates to trigger both types of hernia. We generated the first comparative study of the pig umbilical and inguinal ring transcriptomes, contributing to the understanding of the genetic mechanism involved with these two types of hernia in pigs and probably in other mammals.

Use of bilateral superficial gluteal muscle flaps for the repair of ventral perineal hernia in dogs: A cadaveric study and short case series.

OBJECTIVE: To describe bilateral mobilization of the superficial gluteal muscle (SGM) to treat ventral perineal hernias in dogs. STUDY DESIGN: Cadaveric study and short case series. SAMPLE POPULATION: Male dog cadavers (n = 10) weighing between 5 and 42 kg and three dogs treated for ventral perineal hernia. METHODS: Cadavers were positioned in right and left lateral recumbency to free the origin and insertion of the ipsilateral SGM except for muscle fibers originating on the first tail vertebra and sacrotuberous ligament. The dogs were placed in ventral recumbency to approach the perineum and rotate the muscle flaps. The insertions of the SGM were sutured together ventral to the anal sphincter muscle. The dorsal border of the overlapping tendons was sutured to the anal sphincter muscle, and the ventral border was sutured to the ischiourethralis muscle. The amount of overlap between bilateral flaps was measured. The SGM flaps were used to revise recurrent perineal hernias in three dogs. RESULTS: Superficial gluteal muscle flaps were created without damage to the blood supply in all dogs. The overlap between the bilateral flaps ventral to the anal sphincter measured 0 to 2.4 cm. No recurrence was detected at follow-up (6-12 months) in the three dogs treated with these flaps. CONCLUSION: Superficial gluteal muscle flaps were mobilized without damage to the blood supply and crossed the midline ventral to the anal sphincter. Flaps were used successfully to repair ventral perineal hernias in three dogs. CLINICAL SIGNIFICANCE: Bilateral SGM flaps can be considered to repair ventral perineal hernias.

Repair of a Large Ventral Hernia in a Rhesus Macaque (Macaca mulatta) by Using an Abdominal Component Separation Technique.

Here we present a 32-y-old rhesus macaque (Macaca mulatta) with a large recurrent ventral incisional hernia. The initial surgery included midline celiotomy for treatment of endometriosis, in which the animal developed a hernia that was repaired with interposition of mesh. Hernia recurrence at 1 y resulted in a defect measuring 7 × 13 cm, with loss of abdominal domain. Skin breakdown was noted with areas of exposed mesh through the skin with associated acute on chronic infection. Clinically, the animal was lethargic, not eating, and failing to thrive. The present surgical treatment included midline celiotomy, removal of mesh, and attempted primary fascial closure. Due to the large defect and high tension, the fascia could not be closed. To facilitate closure, abdominal component separation technique was used and consisted of skin and subcutaneous dissection, external oblique muscle release, and dissection between the external and internal oblique musculature. This technique allowed for primary fascial closure and resection of excess diseased skin. A piece of polypropylene mesh was placed in a sublay fashion to reinforce the primary fascial closure. The animal tolerated the procedure well and has demonstrated steady weight gain, with no recurrence at 12 mo. Large ventral abdominal hernia defects in after surgery or trauma in NHP can present reconstructive challenges to veterinary surgeons. Failure to achieve a dynamic, low-tension closure can result in hernia recurrence, necessitating additional operations. Abdominal component separation is not commonly used in veterinary surgery and may be a helpful tool in cases of difficult abdominal reconstructions.

Prosthetic mesh repair of abdominal wall hernias in horses.

Repair of hernias of the abdominal wall of horses is often augmented by inserting a prosthetic mesh. In this review, we describe the various characteristics of prosthetic meshes used for hernia repair and present 2 systems that are used by surgeons in the human medical field to classify techniques of prosthetic mesh herniorrhaphy. Both of these classification systems distinguish between onlay, inlay, sublay, and underlay placements of mesh, based on the location within the abdominal wall in which the prosthetic mesh is inserted. We separate the published techniques of prosthetic mesh herniorrhaphy of horses using this classification system, ascribing names to the techniques of herniorrhaphy where none existed, and report the success rates and complications associated with each technique. By introducing a classification system widely used in the human medical field and illustrating each technique in a figure, we hope to clarify inconsistent nomenclature associated with prosthetic mesh herniorrhaphy performed by veterinary surgeons.

Radiographic and ultrasonographic characteristics of ventral abdominal hernia in pigeons (Columba livia).

Five female egg-laying pigeons presented with painless, reducible, ventral abdominal swellings located between the keel and the pubis, or close to the cloaca. Based on clinical, radiographic, and ultrasonographic examination, these pigeons were diagnosed with ventral abdominal hernia requiring surgical interference. Reduction was successfully performed under general anesthesia. Radiographic and ultrasonographic examinations were beneficial for confirming the diagnosis and visualizing the hernial content for surgical planning. Lateral radiographs were more helpful than ventrodorsal radiographs for identification of the hernial content and its continuation with the abdominal muscles. Ultrasonographic examination offered a non-invasive diagnostic tool that allowed for the differentiation of hernia from other abdominal swellings. In addition, it played a beneficial role in identification of the hernial content and follow up after surgical interference. In conclusion, radiographic and ultrasonographic examinations were beneficial in the diagnosis, surgical planning, and follow up after surgical interference of ventral abdominal hernia in pigeons.

Modified semitendinosus muscle transposition to repair ventral perineal hernia in 14 dogs.

OBJECTIVES: To describe a modified technique of semitendinosus muscle transposition for the repair of ventral perineal hernia. MATERIALS AND METHODS: Retrospective review of case records of dogs with ventral perineal hernia that were treated by transposing the medial half of the longitudinally split semitendinosus muscle of one limb. The transposition of the internal obturator muscle was used when uni- or bilateral rectal sacculation was also present in addition to ventral perineal hernia; colopexy and vas deferens pexy were also performed. RESULTS: Fourteen dogs were included. In addition to ventral perineal hernia, unilateral and bilateral perineal hernia was also present in five and six of the dogs, respectively. The mean follow-up time was 890 days. Ventral perineal hernia was successfully managed by the modified semitendinosus muscle transposition with minor complications in all the dogs included in the study. CLINICAL SIGNIFICANCE: Despite the small number of dogs included, the unilateral transposition of the medial half of the longitudinally split semitendinosus muscle consistently supported the ventral rectal enlargement in perineal hernia without obvious adverse effects.

Surgical repair of a congenital sternal cleft in a cat.

OBJECTIVE: To describe the clinical findings, diagnosis, and treatment of an incomplete cleft of the 5th-8th sternebra and a cranioventral abdominal wall hernia in a 2 month old Ragdoll kitten and to evaluate the short- and long-term outcome. STUDY DESIGN: Clinical report. ANIMALS: Ragdoll cat (n = 1), 2 months old. METHODS: Sternal cleft was confirmed by thoracic radiographs. Computed tomography (CT) was used to plan an optimal surgical approach. A ventral median incision was made, starting at the 3rd sternebra and extended into the abdomen. Ostectomy of the proximal part of the 5th left sternebra was performed. Lateral periosteal flaps were created, unfolded, and absorbable monofilament sutures preplaced to facilitate closure and the repair was reinforced by 2 peristernal sutures. A bone graft was applied, and the free margin of the omentum was sutured to the cranial aspect of the wound. RESULTS: No major complications occurred. At 3 weeks, CT scan confirmed approximation of the hemisternebrae and at 10 months, complete fusion of the hemisternebrae had not occurred, but a strong connection of the sternal bars was present. CONCLUSION: Sternal cleft is a rare congenital abnormality that can be corrected surgically with favorable outcome.

Incisional hernia repair in horses: a cadaveric study of endoscopic component separation.

OBJECTIVE: To report a technique for endoscopic component separation in horses and quantify the amount of body wall advancement obtained. STUDY DESIGN: Descriptive study. ANIMALS: Fresh cadaveric horses (n = 14). METHODS: After a preliminary anatomic study, 7 horses had unilateral endoscopic component separation involving transection of the external abdominal oblique fascia lateral to the rectus abdominis muscle. A laparoscope, placed using a balloon dissector, was used to create an intermuscular working space between the external abdominal oblique fascia and internal abdominal oblique muscle. A single instrument portal was created 10-12 cm medial to the laparoscope portal. Laparoscopic scissors were used to transect the external abdominal oblique fascia, lateral to its insertion to the external rectus sheath, from ≈ 20 cm cranial to the costochondral junction to the level of the superficial inguinal ring. Subsequently, a 30 cm ventral median celiotomy was created and the myofascial advancement was quantified at points 10 and 20 cm cranial to the umbilicus. RESULTS: Endoscopic component separation was successfully completed in all horses. Component separation provided a net mean (± SD) abdominal wall advancement of 3.5 ± 1.3 cm and 3.4 ± 0.5 cm, 10 cm, and 20 cm cranial to the umbilicus, respectively. CONCLUSION: Endoscopic component separation in horses is technically feasible but, as conducted, results in modest abdominal wall advancement.

Rectus abdominis muscle flap for repair of prepubic tendon rupture in 8 dogs.

The clinical use and outcome of the rectus abdominis muscle flap to repair prepubic hernias were evaluated retrospectively. Medical records (2002-2007) of 8 dogs that had a rectus abdominis muscle flap to repair traumatic prepubic tendon rupture were reviewed. Only minor donor site complications were noted, including self-limiting ventral and hind-limb swelling. No long-term complications including recurrence of hernia were noted. The results of this study indicate that the rectus abdominis muscle flap is a clinically useful option for repairing prepubic tendon rupture in dogs.

Clinical anatomy and surgical repair of prepubic hernia in dogs and cats.

Prepubic hernia is a traumatic hernia in small animals, most often associated with severe trauma to the caudal abdomen. Common causes include vehicular trauma, dog fights, and kicks by large animals. Rupture of the prepubic tendon in dogs and of its equivalent in cats results in a ventral abdominal hernia. Due to the traumatic nature of the injury, concurrent injuries are frequently seen. Clinical signs of herniation are often nonspecific, and the resultant hernia may not be readily apparent during routine physical examination. This being so, diagnosis is often based on a thorough physical examination in conjunction with abdominal radiography and, possibly, abdominal ultrasonography. Multiple methods of repair of prepubic hernia have been reported, and survival rates are quite good if concurrent injuries are not severe.

Hernioplastia experimental em coelhos por meio de cartilagem auricular bovina conservada em glutaraldeído / Rabbits experimental hernioplasty by means of bovine auricular cartilage preserved in glutaraldehyde

Avaliou-se a viabilidade do emprego da cartilagem auricular bovina conservada em glutaraldeído a 4 por cento na hernioplastia experimental, empregando-se seis coelhos adultos, machos, da raça Nova Zelândia. Para obtenção da hérnia incisional, removeu-se um segmento elíptico de 3cm de comprimento por 1cm de largura, no ponto central à primeira incisão, envolvendo fáscia e tecido muscular, na região da cicatriz umbilical. Dois animais de cada vez foram sacrificados aos 15, 30 e 45 dias após a cirurgia. Nos sacrificados aos 15 dias, observaram-se áreas focais de inflamação, caracterizadas por abscesso e fístula. À microscopia, observou-se área de inflamação e necrose próxima à periferia do implante. Nas amostras colhidas dos animais sacrificados aos 30 dias, não foram evidenciadas alterações clínicas relevantes. Desses, um animal apresentou à microscopia intensa proliferação fibroblástica, moderada neovascularização e células inflamatórias predominantemente mononucleares. Dos sacrificados aos 45 dias, em um ocorreu aderência de alça intestinal ao implante. É possível inferir que o material implantado apresentou satisfatória compatibilidade com o tecido receptor. Conclui-se que o implante de cartilagem auricular bovina conservada na hernioplastia experimental em coelhos apresentou evidências de boa integração tecidual e cicatrização, não havendo eliminação do material implantado.

The auricular cartilage preserved in 4 percent glutaraldehyde was used for experimental hernioplasty in six male, adult, New Zealand rabbits. To create an incision hernia, an elliptic tissue fragment three centimeter-long and one-centimeter wide was removed at a point centrally located from the first incision, embracing fascia and muscle tissue, from the area of umbilical scar. Animals were euthanized, two at a time, 15, 30, or 45 days after surgery. In the animals euthanized after 15 days focal areas of inflammation were observed, characterized by abscesses and fistulas. The histological section showed areas of inflammation and necrosis next to the periphery of the graft. In the animals euthanized after 30 days, there was no evidence of clinical alterations. Microscopic diagnosis of one of these animals showed intense fibroblastic proliferation, moderate neovascularization and inflammatory cells, predominantly mononuclear. One of the animals submitted to euthanasia at 45 days presented at necropsy adherence of bowel to the graft and impaired reconstitution of the parietal peritoneum. It is possible to infer that the grafted material presented satisfactory compatibility with the receptor tissue. Thus, it may be concluded that auricular bovine cartilage grafts preserved in 4 percent glutaraldehyde in experimental hernioplasty in rabbits presented evidence of good tissue integration and healing, with no elimination of the grafted material.

Evaluation of common vaginal tunic ligation during field castration in draught colts.

The objective of this study was to determine if ligation of the common vaginal tunic could prevent or reduce the incidence of omental herniation and eventration in draught colts undergoing routine field castration. It was found that common vaginal tunic ligation, while not completely preventing omental herniation and evisceration, significantly reduced the incidence of these complications and should be considered in those males deemed at increased risk of significant post castration complications.

Survival and complication rates in 300 horses undergoing surgical treatment of colic. Part 3: Long-term complications and survival.

REASONS FOR PERFORMING STUDY: Few studies have evaluated long-term survival and complication rates in horses following surgical treatment of colic, making it difficult to offer realistic advice concerning long-term prognosis. OBJECTIVE: To review the complications occurring after discharge from hospital and survival to >12 months after surgery of 300 horses undergoing exploratory laparotomy for acute colic. Pre-, intra- and post operative factors that affected long-term complications and long-term survival were assessed. METHODS: History, clinical findings, surgical findings and procedures and post operative treatments of 300 consecutive surgical colic cases (1994-2001) were reviewed. Long-term follow-up information was retrieved from case records and telephone enquiries from owners. RESULTS: The long-term (>12 months) survival rate for 204 horses discharged after colic surgery and for which follow-up information was available was 84%. The most common complication after discharge was colic, affecting 35.1% of horses following a single laparotomy. Colic was most common in horses that had had small intestinal obstructions, bowel resection or post operative ileus. Abdominal adhesions were most common in horses that presented with severe colic due to strangulation of small intestine. Ventral hernia formation occurred in 8% of horses, and was most common in horses that had had post operative wound drainage or infection. CONCLUSIONS: This study identified various factors that appear to predispose horses to long-term complications after colic surgery. POTENTIAL RELEVANCE: Further evaluation of strategies that might reduce the incidence of such complications are needed; in particular, the value of intraperitoneal heparin should be evaluated, and procedures designed to reduce the rates of wound drainage and infection assessed.

[Trevira: a new polyester implant for the treatment of incisional hernia. Results of an experimental study]. / Trevira: une nouvelle prothèse en polyester pour la cure des éventrations. Résultats d'une étude expérimentale.

OBJECTIVE: The synthetic implant meshes in clinical use for the treatment of abdominal hernias are generally made of polyester in France and of polypropylene in Germany. Serving as an implant material for the replacement of the cruciate ligament, the Trevira is another polymer of polyester in clinical use with excellent results. This animal trial was performed to ascertain whether it offers any advantages over polypropylene for abdominal incisional hernia repair. MATERIAL AND METHODS: [corrected] In 12 pigs 10 x 10 cm of the abdominal wall preserving the peritoneum was resected and subsequently implanted a 15 x 15 cm synthetic mesh of polyethylene terephthalate (Trevira) in half of them and of polypropylene (Prolene) in the other half using a sublay technique. After two and six month the implant size was measured and the extend of the foreign body reaction determined by the microscopically presence of foreign body giant cells. RESULTS: No significant differences concerning the implant size were shown between the two groups at any of the time periods. The acute inflammatory reaction observed was significantly higher at the polypropylene than at the polyethylene terephthalate implant (number of giant cells after 2 month: Prolene 2.2 +/-0.4, Trevira: 0.8 +/-0.2, after six month: Prolene: 4.6 +/-1.3, Trevira: 1.1 +/-0.5). In contrast to the polyethylene terephthalate all polypropylene samples showed calcification areas after six month. CONCLUSION: In this animal trial Trevira mesh showed a high biocompatibility with a low foreign body reaction. It appears to be a promising new implant for the treatment of hernia.

Use of laparotomy in a staged approach for resolution of bilateral or complicated perineal hernia in 41 dogs.

OBJECTIVE: To evaluate the value of laparotomy as the initial step in the treatment of bilateral or complicated perineal hernia (PH) in dogs. STUDY DESIGN: Retrospective study. ANIMALS OR SAMPLE POPULATION: Forty-one dogs with PH. METHODS: Dogs with bilateral or complicated PH treated by a 2-step approach between November 1997 and December 2001 were studied. Inclusion criteria for complicated PH were: recurrence of PH, unilateral PH with a major rectal dilatation, PH with a concurrent surgical prostatic disease, and PH with retroflexed bladder. Colopexy, vas deferens pexy, cystopexy, and prostatic omentalization were performed during laparotomy as needed. Later, PH was performed by internal obturator muscle flap (IOMF) or if there was a perineal rent or weakness on the contralateral side, appositional herniorrhaphy was performed. Outcome was followed for >/=6 months. RESULTS: PH were bilateral (20 dogs) or unilateral (21). Twenty-one (51%) dogs had prostatic disease (clinical or ultrasonography diagnosis; 17 confirmed histologically) and 12 (29%) had urinary bladder retroflexion. Forty-one colopexies, 32 vas deferens pexies, 6 cystopexies, and 9 prostatic surgeries (omentalization or perineal cyst resection) were performed. PH was performed 2-20 days (median, 6 days) later: 61 IOMF transpositions, 13 appositional. Mean follow-up time was 26.6 months (range, 6-54 months, median, 27 months). PH was resolved in 37 (90%) dogs; 4 dogs had recurrence, and all occurred within 6 months. Thirty-eight (92%) dogs had an improved quality of life (good in 34 dogs, fair in 4 dogs). Wound complications occurred in 7 dogs (17%). Postoperative urine dribbling occurred in 15 dogs (37%) and was irreversible in 7 dogs (17%). Postoperative fecal straining persisted in 18 dogs (44%), and was permanent in 4 dogs (10%). Fecal incontinence did not occur. CONCLUSIONS: In bilateral or complicated PH, fixation of the urinary bladder and colon, and treatment of prostatic disease increase the chances of resolution. Emptying of the perineal space by organ pexy allows improved observation during herniorrhaphy. Despite a 90% clinical resolution, dogs with complicated PH treated by a 2-step protocol may have persistent urinary and fecal disorders. CLINICAL RELEVANCE: To improve the prognosis of bilateral or complicated PH, investigation and treatment of concomitant lesions (rectal, prostatic, bladder) should be part of a rational surgical strategy using a 2-step protocol.

Routine castration in 568 draught colts: incidence of evisceration and omental herniation.

REASONS FOR PERFORMING STUDY: Castration is one of the most common routine surgical procedures performed in the horse, from which a number of potential complications can arise. We undertook a prospective evaluation of short-term complications associated with castration of draught colts over a 3-year period (1998-2000). OBJECTIVES: To compare castration complications in a large number of draught foals with previously published literature. METHODS: Five hundred and sixty-eight draught colts, age 4 or 5 months, were castrated in field conditions. Foals were observed for complications for 24 h post operatively. RESULTS: There was no significant difference in complication rates between open and closed surgical techniques. Inguinal/scrotal hernia rate was 4.6% (26/568) prior to surgery, and evisceration of the small intestine occurred in 4.8% (27/568). Foals observed to eviscerate underwent immediate surgical correction with an overall survival rate of 72.2% (13/18). Omental herniation was seen in 2.8% (16/568) of colts. CONCLUSIONS: This study showed no difference between the closed and open techniques of castration and the rate of omental herniation or evisceration. The evisceration rate in combination with the omental and presurgical herniation rates approached 12.2%, which is high enough to warrant further examination. POTENTIAL RELEVANCE: Future investigation should help to assess predisposing factors for evisceration. Regardless of the technique employed, herniation appears to pose a significant risk to draught foals undergoing castration.