EQUUS - - Eq Casereport -

Ab­dom­i­nal her­nias, the un­nat­u­ral protru­sion of in­tes­tine or other tis­sues through an open­ing in the body, can de­velop from sev­eral causes. Some are sec­ondary to trauma, in­clud­ing post­op­er­a­tive her­nias, which oc­cur when ab­dom­i­nal con­tents press through an in­com­pletely healed in­ci­sion site in the ab­dom­i­nal wall. Horses can also de­velop her­nias from nat­u­ral causes. Two types of con­gen­i­tal her­nia are most com­mon:

Um­bil­i­cal her­nias may oc­cur when the um­bil­i­cal ring—the dense, fi­brous tis­sue that sur­rounds the um­bili­cus—fails to close prop­erly af­ter the foal is born. Swelling may ap­pear at the foal’s navel within the first few weeks of life. Smaller her­nias, of less than three cen­time­ters, may re­solve with­out treat­ment as the foal grows. Your vet­eri­nar­ian may rec­om­mend man­u­ally mas­sag­ing the con­tents of the her­nia back up into the ab­domen each day un­til the ring closes on its own. If the her­nia is still present af­ter six months, or if it is large and pro­tu­ber­ant to start with, sur­gi­cal clo­sure may be nec­es­sary.

In­guinal her­nias oc­cur in one of the in­guinal canals—nat­u­ral open­ings in the ab­dom­i­nal wall where blood ves­sels, nerves and other struc­tures pass through to the struc­tures of the groin, in­clud­ing the testes in male horses and the ud­ders in mares. When ab­dom­i­nal tis­sues ex­tend into the testes, they may also be called scro­tal her­nias. In­guinal her­nias can oc­cur as con­gen­i­tal de­fects in foals or in mares who ex­pe­ri­ence dif­fi­culty giv­ing birth or other trauma, but they are most com­mon as a com­pli­ca­tion fol­low­ing cas­tra­tion. Sur­gi­cal cor­rec­tion is usu­ally re­quired.

Another, rarer, form of ab­dom­i­nal her­nia is di­aphrag­matic— when the in­testines, stom­ach or other tis­sues may pro­trude into the tho­racic cav­ity through tears or de­fects in the di­aphragm, the mus­cu­lar par­ti­tion that sep­a­rates the heart and lungs from the di­ges­tive or­gans. This can oc­cur where the esoph­a­gus passes through to the stom­ach (called a hi­atal her­nia) or through a tear re­sult­ing from trauma. Sur­gi­cal re­pair of a di­aphrag­matic her­nia is pos­si­ble, es­pe­cially if the de­fect is small and the dam­age to the in­testines is min­i­mal. But the prog­no­sis is gen­er­ally poor: In one study of 44 horses ad­mit­ted to ei­ther the New Bolton Cen­ter at the Univer­sity of Penn­syl­va­nia or the Mar­ion duPont Scott Equine Med­i­cal Cen­ter in Lees­burg, Vir­ginia, 18 died or were eu­tha­na­tized prior to surgery, and only five sur­vived one year post-surgery. In another study of 31 horses ad­mit­ted to Hag­yard Equine Med­i­cal In­sti­tute in Lex­ing­ton, Ken­tucky, and the Univer­sity of Cal­i­for­nia– Davis Vet­eri­nary Med­i­cal Teach­ing Hos­pi­tal, only 46 per­cent (six of 13) who un­der­went surgery sur­vived to dis­charge, for an over­all sur­vival rate of 23 per­cent for those di­ag­nosed with the con­di­tion.

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