Bovis ISSN 2398-2993
Umbilical hernia: surgical correction
Contributor(s): Ash Phipps
, Adam Dunstan-Martin
There is often a hereditary element to this condition. Careful consideration should be given as to whether it is appropriate to correct this deficit in animals which are to be used for further breeding.
- In bovines umbilical hernias are the most common congenital defect.
- Umbilical hernias can be divided into 3 categories:
- Uncomplicated umbilical hernia.
- Umbilical hernia with subcutaneous infections (abscess).
- Umbilical hernia with umbilical remnant infection.
- Cause: failure of normal development and closure of umbilicus, infection at site of umbilicus, manual breakage of the umbilicus, clamping or ligation of the umbilical cord and potentially excessive straining.
- Diagnosis: clinical signs, physical examination and ultrasonography.
- Treatment: various medical and surgical options.
- Prognosis: usually good.
- Occurs in an estimated 4 to 15% of calves.
- Reported most frequently at 5-7 weeks after birth.
- Females are much more frequently affected than males.
- Seems to occur more frequently in Holstein Friesian calves. However it can occur in any breed of cattle.
- No intervention.
- Less invasive non-surgical treatment.
- Invasive surgical treatment (ligation of the hernial sac, suturing of the hernial sac, open herniorrhaphy and closed herniorrhaphy).
- Failure of normal development and closure of the umbilicus - reasons for failure of closure are unknown.
- Postulated reasons include:
- Heritable factors.
- Inflammation of the umbilicus.
- Inflammation and sepsis of the umbilicus.
- Post - calving infection of umbilical infection.
- Manual traction and breakage of the umbilicus.
- Clamping or ligation of the umbilical cord at calving (particularly post cesarean section).
- External trauma to umbilicus.
- Excessive straining.
- Cloned calves (less collagen in the ventral abdominal wall).
- Hypoplasia of the abdominal musculature.
- Multiple births (twins, triplets etc).
- Short gestation calves.
- Failure of the abdominal musculature to close properly around the umbilical structures.
Timecourse (incubation, duration)
- Small umbilical hernias, with an internal ring size of <2 cm diameter rarely cause strangulation as the body wall deficit is generally too small for abdominal contents other than omentum to pass through.
- Umbilical hernias, with an internal ring size of >2 cm diameter, are unlikely to repair naturally, and represent a potential site of abomasal and intestinal incarceration.
With umbilical defects >5cm and surgical intervention is not possible or not feasible, the animal may be kept and fattened for slaughter. However, this does carry a minor risk of entrapment and strangulation of abdominal contents.
- Usually present shortly after birth.
- Non-painful (non-strangulated and non-infected hernias).
- Variable contents - omentum, small intestine or abomasum.
- Size and shape of hernial ring varies.
- <2 cm diameter opening usually resolve spontaneously rarely cause strangulation as the body wall deficit is generally too small for abdominal contents other than omentum to pass through.
- 2-5 cm may require treatment.
- >5 cm require treatment - usually surgical.
- Nature of umbilical ring determines degree of fibrosis and possibility of suture retention.
- External digital palpation.
- This is useful (even at time of surgery)
- Particularly for non-reducible hernias to identify contents of hernial sac and differentiate from umbilical abscessation.
Confirmation of diagnosis
- Discriminatory diagnostic features:
- Clinical signs
- Close examination of the umbilical region.
- Definitive diagnostic features:
Gross autopsy findings
- Variable-sized defect in abdominal musculature at umbilicus with variable sized hernial sac and contents.
- Omphaloarteritis. Omphaloarteritis/phlebitis
- Acquired hernia.
- Rupture of abdominal wall.
- Umbilical abscess.
- Urachal cysts/rupture.
- Management of an umbilical hernia in a young calf .
- Recent references from PubMed and VetMedResource.
- Sutradhar B C, Hossain M F, Das B C, Kim G & Hossain M A (2009) Comparison between open and closed methods of herniorrhaphy in calves affected with umbilical hernia. J Vet Scu 10 (4), 343-347 PubMed.
- Herrmann R, Utz J, Rosenberger E, Doll K & Distl O (2001) Risk factors for congenital umbilical hernia in German Fleckvieh. Vet J 162 (3), 233-240 PubMed.
- McIlwraith C W & Robertson J T (1998) Herniorrhaphy using synthetic mesh and a fascial overlay. Equine surgery advanced techniques 2, 365-370.
- Virtala A M K, Mechor G D, Gröhn Y T, Erb H N (1996) The effect of calfhood diseases on growth of female dairy calves during the first 3 months of life in New York State. J Dairy Sci 79, 1040–1049 PubMed.
- Gilman J P W & Stringam E W (1953) Hereditary umbilical hernia in Holstein cattle. J Hered 44 (3), 113-116.
Other sources of information
- Anderson D E & Rings M (2008) Current veterinary therapy: food animal practice. Elsevier Health Sciences.
- Divers T J & Peek S (2007) Rebhun's diseases of dairy cattle. Elsevier Health Sciences.
- Fubini S L & Ducharme N (2004) Farm animal surgery. Elsevier Health Sciences.