Page 854 - Equine Clinical Medicine, Surgery and Reproduction, 2nd Edition

Gastrointestinal system: 4.2 The lower gastrointestinal tr act 829

VetBooks.ir rupture in the adult can occur in both sexes and pro- Aetiology/pathophysiology
Scrotal hernias can be direct or indirect. In an indirect
duces similar signs.
Differential diagnosis hernia, the herniated intestine is located inside the vag-
inal tunic beside the testis. In a direct hernia, the intes-
Non-ruptured inguinal hernia, scrotal haematoma, tine herniates through a rent in the peritoneum and lies
seroma or hydrocoele should be considered. subcutaneously. Indirect hernias are more common.
The condition may be congenital or acquired.
Diagnosis Congenital hernia in the foal is present at birth
Physical examination and haematology are usually in and is considered an inherited defect. It is secondary
the normal range unless there is intestinal strangu- to an abnormal vaginal ring. Acquired hernias in the
lation or concomitant disease. Palpation of intestine adult are usually unilateral and may occur second-
outside the inguinal region and the presence of swell- ary to conditions that increase the intra-abdominal
ing and abrasions are diagnostic. Ultrasonographic pressure such as breeding or trauma. They can also
examination of the region may reveal loops of small develop post castration for up to a few days.
intestine surrounded by subcutaneous accumulation
of fluid. Absence of the vaginal tunic enclosing the Clinical presentation
intestine may be observed. If strangulation is pres- Congenital hernia in the foal
ent, the intestinal wall may be thickened, and intes- This is usually observed in the first few days of
tinal motility decreased. life. Standardbred and draught breeds are predis-
posed. It may be unilateral or bilateral and is often
Management observed after straining to pass meconium. On pal-
Surgical treatment is advisable to avoid strangula- pation of the scrotum, fluid-filled intestinal loops
tion, local adhesions of the small intestine or total can be detected and borborygmi may be audible
rupture. An inguinal approach is selected, and the locally. Most of the hernia is easily reducible, but
hernia is reduced. If present, the testicle is removed, re- herniation occurs immediately when pressure is
and the vaginal tunic closed. Closure of the vaginal removed. The foal may present with signs of colic if
tunic may be impossible in some cases because of strangulation occurs; however, this is rare.
oedema and trauma. The external inguinal ring is
closed subsequently. If the skin has been stretched
excessively, part of it is resected or a drain is placed 4.156
locally to avoid seroma formation. The other testicle
should also be removed.

Prognosis
The prognosis is good if there is absence of stran-
gulation or full-thickness trauma at the level of the
skin. Complications are usually limited to formation
of seroma and local infection. Postoperative ileus is
also possible.

SCROTAL HERNIA

Definition/overview
An inguinal hernia results from passage of abdomi-
nal contents into the inguinal canal. If the intestine
passes through the external inguinal ring and into Fig. 4.156 A stallion affected with a severe left
the scrotum, it is a scrotal hernia (Fig. 4.156). scrotal hernia.