Equis ISSN 2398-2977

Inguinal ring: hernia

Contributor(s): David Moll, Prof Jonathon Naylor, Vetstream Ltd

Introduction

  • Inguinal hernia: herniation of abdominal contents (small intestine) from the abdominal cavity, through the deep inguinal ring into the inguinal canal.
  • Scrotal hernia: further herniation through the superficial inguinal ring into the scrotum.
  • Cause: congenital, secondary to trauma (fall or compression of flanks) or castration   Testis: castration - post-operative complications  , after covering a mare.
  • Signs: may be visually apparent or inapparent, colic.
  • Diagnosis: history, clinical signs.
  • Treatment: rectal traction, external manipulation or surgery.
  • Prognosis: generally good with non-strangulating hernias.

Pathogenesis

Etiology

  • Congenital.
  • Trauma.
  • Post-surgical.
  • Increased intra-abdominal pressure (and relative position and shape of inguinal ring).

Pathophysiology

  • Unnoticed congenital inguinal hernia may worsen following castration.
  • Increased intra-abdominal pressure (due to resistance of horse during castration) may force intestine or omentum through vaginal ring into vaginal cavity of inguinal canal.
  • Same occurs on attempting to stand after anesthesia, or when rearing, or covering a mare.
  • During standing up or rearing inguinal canal is relatively lower than abdominal cavity   →   increases load on vaginal ring   →   increased chance of herniation.
  • Sternal recumbancy and just as horse is about to stand up   →   flexed hindleg   →   opens inguinal canal   →   period of risk of herniation.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Boerma S, Back W & Sloet van Oldruitenborgh-Oosterbaan M M (2012) The Friesian horse breed: A clinical challenge to the equine veterinarian? Equine Vet Educ 24 (2), 66-71 VetMedResource.
  • Cousty M, Tricaud C, Picandet V & Geffroy O (2010) Inguinal rupture with herniation of the urinary bladder through the scrotal fascia in a Shetland pony foal. Equine Vet Educ 22 (1), 3-6 VetMedResource.
  • Schumacher J & Perkins J (2010) Inguinal herniation and rupture in horses. Equine Vet Educ 22 (1), 7-12 VetMedResource.
  • Ivens P A S, Piercy R J & Eliashar E (2009) Inguinal herniation of the large colon in a cob gelding four weeks after castration. Vet Rec 165 (13), 380-381 PubMed.
  • Marien T et al (2001) Laparoscopic testis-sparing herniorrhaphy - A new approach for congenital inguinal hernia repair in the foal. Equine Vet Educ 13 (1), 32-35 VetMedResource.
  • Gaughan E M (1998) Inguinal hernias in horses. Comp Cont Educ 20, 1057-1059 VetMedResource.
  • Klohnen A and Wilson D G (1996) Laparoscopic repair of scrotal hernia in two foalsVet Surg 25 (5), 414-416 PubMed.


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