1. Hernia is defined as a protrusion of an organ or tissue through an abnormal opening in the wall of the cavity that normally contains it. 2. Hernias are classified based on location, contents, cause, and degree of complications. Common types include ventral, inguinal, diaphragmatic, and umbilical hernias. 3. Clinical signs include swelling at the hernia site. Treatment options range from conservative bandaging to radical surgery to repair the defect and prevent recurrence, sometimes using prosthetic mesh.

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