Umbilical Hernia/Strangulated Hernia

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Description:

A hernia is the protrusion of abdominal contents through an opening in the body wall. Hernias can be either congenital or acquired and can occur either through natural openings or induced ones. In calves, the most common form of hernia is the umbilical hernia where potions of the abdominal contents protrude out through the natural opening in the ventral abdomen left by the umbilicus. Umbilical hernias in calves may be more common in the Holstein-Friesian breed. While many calves can live with umbilical hernias without any problems, there is a risk that a loop of intestine can slip though the opening and become twisted. This is referred to as a strangulated hernia and it is a surgical emergency.

Etiology:

Umbilical hernia is the most common form of congenital defect in calves. It appears that Holstein-Friesian breed cattle are more commonly affected. An umbilical hernia forms when the opening in the ventral abdomen through which the umbilicus protrudes (the umbilical ring) fails to close properly after birth. Some factors that can increase the likelihood of this happening are cutting the umbilicus off close to the body wall, and excessive traction being applied to an oversized fetus during delivery. A strangulated hernia develops when a loop of intestine slips through the umbilical ring and twists on itself, thus cutting off the blood supply to the tissue. The section of bowel is usually a loop of small intestine but it can be cecum or large colon, too.

Symptoms:

Strangulating hernias are painful because the blood supply to the affected segment of bowel is compromised. This condition traps gas within the twisted segment and if left untreated, the segment will eventually die due to a lack of blood flow. The signs associated with a strangulated umbilical hernia include a warm, swollen, firm and painful hernia sac accompanied by signs of colic.
 

Diagnosis:

Diagnosing a strangulated umbilical hernia can be done by observing signs such as a swollen, painful, firm umbilical sac along with fine needle aspiration of the swelling to differentiate it from an umbilical abscess.

Prevention:

Preventing a strangulated inguinal hernia can be accomplished by repairing an umbilical hernia before any bowel has a chance to become strangulated inside the hernia sac. Repair of umbilical hernias can be attempted surgically and non-surgically. Non-surgical repair involves reducing any herniated abdominal contents and then placing an elastic bandage around the belly to keep the contents in their normal place long enough for the umbilical ring to close by itself. Surgical repair requires freeing any contents of the umbilical sac, reducing them, and suturing the umbilical ring shut.

Treatment:

Strangulated umbilical hernias require surgical repair.
 

Sources: 

Smith, B.P. Large Animal Internal Medicine, 3rd Ed. Mosby-Elsevier Publishing. St. Louis, MO. 2009. PP.289, 651.

Merck Veterinary Manual Online: http://www.merckvetmanual.com/mvm/index.jsp?cfile=htm/bc/20207.htm
 

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