Surgical Management of External Hernia with Entero-Mesenteric Incarceration in an Uda Ewe

Abstract

Introduction: External hernias with incarcerated contents pose a significant risk to animal patients, and prompt attention is crucial to prevent complications. The present study aimed to describe the clinical findings, diagnosis, and successful surgical management of an external hernia with incarcerated entero-mesenteric content in a 2-year-old Uda ewe.
Case report: A 2-year-old Uda ewe, weighing 40 kilograms, was presented to the Veterinary Teaching Hospital, University of Jos, Nigeria, with a large swelling on the right ventrolateral abdominal wall, attributed to a traumatic incident caused by a horn gore from a bull. Clinical examination revealed a large protrusion on the right ventrolateral abdominal wall region, with a soft, tender swelling beneath. The swelling was partly reducible through a partially palpable hernia ring. The vital parameters (rectal temperature, pulse, and respiratory rates) and hematological parameters such as complete blood count were within normal reference ranges. A clinical diagnosis of incarcerated external hernia was made based on the animal's history and clinical findings. The ewe underwent surgical correction via herniorrhaphy using a continuous suture pattern. The procedure involved meticulous blunt and sharp dissection to separate the incarcerated entero-mesenteric tissues, followed by a two-layer closure. The peritoneum, rectus abdominis, and transversus abdominis muscles were sutured as the first layer using a simple novel technique. This technique involved taking continuous sutures from both ends of the hernia ring toward the center and securing with a surgeon's knot at an equidistant point, which helped evenly distribute the tension along the length of the hernia ring and prevented tissue tearing. The internal and external oblique muscles were sutured as the second layer, which further strengthened the repair. The skin sutures were removed on postoperative day 10, and the ewe recovered without complications.
Conclusion: The present study highlighted the pivotal role of timely detection, precise diagnosis, and surgical intervention in managing external hernias with incarcerated content, which can significantly impact the outcomes in ruminants.