ISSN 2398-2977      

Umbilicus: hernia

pequis
Contributor(s):

Graham Munroe


Introduction

  • Second most common congenital defect in horses. Frequency in foals ranges from 0.5-2%.
  • Cause: failure of normal development and closure of umbilicus, infection at site of umbilicus, manual breakage of the umbilicus, ligation of the cord, excessive straining and colic.
  • Signs: swollen navel.
  • Diagnosis: clinical signs, physical examination, ultrasonography.
  • Treatment: various medical and surgical options, eg surgical reduction and repair.
  • Prognosis: good, can be complications.

Pathogenesis

Etiology

  • Reason for failure of closure is unknown.
  • Postulated reasons include umbilical cord inflammation and inherited predisposition.
  • Strong hereditary link in Thoroughbreds Thoroughbred and Quarterhorses Quarterhorse.

Predisposing factors

General

  • Breed.
  • Infection.

Specific

  • Traction on umbilicus during foaling.
  • Post-foaling umbilical infection.
  • External trauma to umbilicus, ie breakage or ligation.

Pathophysiology

  • Failure of the abdominal musculature to close properly around the umbilical structures.

Timecourse

  • Small umbilical hernias, with an internal ring size of <2 cm diameter, generally correct themselves without treatment within 6-12 months.
  • Umbilical hernias, with an internal ring size of >2 cm diameter, are unlikely to repair naturally, and represent a potential site of bowel incarceration.

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.
  • Bodaan C J et al (2014) Extensive umbilical herniation of the large colon in a foal. Equine Vet Educ 26 (7), 341-344 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.
  • Smith M (2006) Management of umbilical disorders in the foal. In Pract 28 (5), 280-287 VetMedResource.
  • Orsini J A (1997) Management of umbilical hernias in the horse, treatment options and potential complications. Equine Vet Educ 9 (1), 7-10 VetMedResource.
  • Rijkenhuizen A B M, van der Velden M A & Back W (1997) Incarcerated umbilical hernia with enterocutaneous fistulae in two foals. Equine Vet Educ 9 (1), 3-6 VetMedResource.
  • Peyton L C (1981) Surgical correction of equine umbilical hernias. Vet Med Small Anim Clin 76 (8), 1212-1215 PubMed.

Other sources of information

  • Barrelet A (1999) Investigation and Management of Foal Umbilical Disorders. In: Proc 38th BEVA Congress. pp 8-10.

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