1. Hernia Dr. Rekha Pathak, Senior scientist, IVRI
• Def:
• Protrusion of body
cavity contents
• Into normal / Abnormal
opening in the wall of
that cavity
• To lie beneath the intact
skin or to occupy
another body cavity

2. Constituent of hernia
Ring, Sac and Contents
• H. Ring:
• Rupture of abdominal
wall- Ventral hernia
• Diaphragm is the
limiting wall: DH
• Normal opening/
Passage: Inguinal ring /
canal

3. Sac
• In external hernia-
• Skin
• M.fibres
• Fibrous tissue
• Parietal peritoneum

4. Contents
• Intestine
• Omentum
• Liver
• Spleen
• Bladder
• uterus

5. Classification of hernia
• 1. OCCURRENCE
• Congenital
• Aquired
• 2. LOCATION:
External : has ring , sac and contents
Eg: ventral, lateral , inguinal (bubonocele), scrotal
umblical(exomphalos, omphalocele) , perineal

6. Internal: no sac
EG. DH, gut- tie (occasional)
Interstitial : between the abdominal muscles

7. Classification of hernia
• 3. According to contents
• Enterocele
• Epiplocele
• Enteroepiplocele
• Gastrocele
• Reticulocele
• Vesicocele
• Hysterocele

8. Classification of hernia
• 4. Depending on cause:
• Traumatic H.
• Infectious H.

9. • 5.Based on functional
alteration
• Reducible- contents returned
through ring into original
position
• Irreducible – adhesions(sac
and contents)
• Incarcerated- voluminous
contents due to venous
congestion
• Strangulated- necrosis and
extensive adhesions

10. Diagnosis
• Symptoms:
• 1. Physical :
• Swelling – variable in
size
• (abscess, hematoma
, cyst, neoplasm )-
aseptic exploration

11. • Palpation of ring
• Consistency of sac: enterocele(elastic), epiplocele
(doughy)

12. Diagnosis
• Functional symptom
• Absent in reducible and
non- complicated
hernia
• Colic in incarcerated
hernia
• Severe pain, temp.etc

13. Radiography

15. Complications of hernia
• Adhesions
• Hydrocele of sac
• Incarceration-absorption of water in enterocele-
making reduction difficult
• Torsion
• Strangulation-called as acute hernia

16. Umblical hernia
• Common in dogs and
bovine calves
• Rare in lambs & kids
• No gender
predisposition, among
ruminants- common in
females

17. • Congenital/ aquired
• Congenial – hypoplastic
rectus muscles and
aponeurosis of oblique
muscle(wide thin linea
alba from xiphoid to
pubis )- DH

18. • Aquired: cord cut close
to abdomen
• Bitch chews
• Rough handling
• Excessive
straining(diarhoea/
constipation)

19. • Infection of cord
• Congenital/ aquired –
primarily hereditary –
size- H.ring- recessive
genes(2 or more)

20. Clinical signs
• Swelling
• Ring
• Contents – omentum / fat/ intestinal loop
• More voluminous content/ adhesions- ring
not felt- RG diagnosis

21. Treatment
• Conservative: belly bandages/ wooden or
metal clamps
• Reducible- small content
• Dorsal recumbency- reduce manually the
contents- clamp the empty sac- jaw of clamp
and tighten the nuts

22. • Aim : to obliterate hernial sac – stimulate
healing of the ring
• Sac – necrosis- sloughs down – 10- 12 days
• Skin wound- heals by 2nd intention
• Inject irritants – HCL/ H2so4- around ring-
stimulate fibrous tissue formation

23. Radical surgery
• 12-24 hrs fasting
• Local infiltration/GA
• Dorsal recumbency

24. • Midline/ extended past
craniocaudal limits on
the ring

25. • In large hernia- elliptical
incision – removal of
isolated skin

26. • Open the sac
• More
content and
small ring-
go for
kelotomy

27. • Reducible – invert the
contents
• if large and
adhesions: remove

28. 1. Bet. Sac(inner wall)
and contents
2. Bet. Sac with
skin/muscles
 Edge of ring –
debrided
 If sac is big- remove
the sac

29. • Series of simple interrupted / horizontal
mattress
• Chromic catgut/ silk / monofilament/ steel/
nylon
• Overlapping mattress- non – absorbable-
tighten from centre to periphery

30. • Wide wall disruption-
tension on apposition of
edges
• To relieve- external
laminae of rectus
sheath- incised on each
side of incision – relieve
tensionand achieve
apposition of sutured H.
ring
• Alternatively,
Hernioplasty

31. Hernioplasty
(Hernial Prosthesis)
• Large h. ring
• Weak spot(scar) present
• Large loss of tissue on edges
• Allow approximation
without tension
• Bridge the gap
• Avoid reccurrence of hernia

32. Living (fresh and preserved)
• Skin- full
thickness, autologous
whole skin graft (DH)
• Duramatter
• Muscle
• Fascia lata- lumbar
area- no tissue reaction

33. Non – living
• Metallic : stainless
steel
• Synthetic:
Nylon, teflon, Marseli
ne, Marlex, dacron, et
c
• Mesh/sheets

34. • Mesh – prefferred
1. More flexibility
2. Permits infiltrative fibrosis-
scaffold – ingrowth- fibrous CT
3. Minimal tissue reaction and
adequate strength
4. 15x30 cm

35. Techique
• Remove sharp ends and
corner
• Close muscle defect
• Edge of mesh – sutured-
surrounding fascia with
non- absorbable
material in a horizontal
mattress pattern
• Close the skin