Hernia

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  • A hernia is defined as the displacement of the small intestine through a normal or pathologic foramina.

Pathogenesis

  • Associated with trauma or the weakening of tissues.
    • For example,
      • Old age
      • Pregnancy
      • Straining
      • Wound dehiscence.
  • Most hernias are external
    Diagram of a hernial sac (Courtesy of Elspeth Milne)
    • Contents pass through a hernial ring in the abdominal wall.
    • Are covered with parietal peritoneum, soft tissue and skin.
      • A hernial sac.

Sequelae

  • The sequelae depend on whether the hernia is reducible, or is an incarceration.


Reducible hernia
  • The hernial contents are freely moveable.
  • There are NO sequelae.


Incarceration
  • The small intestine contents are trapped.
    • The hernia is non-reducible.
  • Venous drainage is obstruced.
    • Oedema
    • Congestion
  • Adhesions form between the contents and the sac.
  • Accumulated gas/ ingesta distends the herniated viscus.
  • Obstruction of lumen leads to
    • Rupture
    • Peritonitis
    • Death.

Types of hernia

  • Umbilical - usually congenital.
  • Diaphragmatic - common following road traffic accidents in the dog and cat.
  • Inguinal/scrotal - may be:
    • Congenital
    • Acquired
      • E.g. post castration of stallion
  • Perineal - old male dogs with prostate enlargement.
  • Ventral -wound site breakdown, old mares
  • Omental/mesenteric - internal hernias.
Volvulus (Courtesy of Bristol BioMed Image Archive)