The Pharma Innovation Journal 2021; S P-10(7): 929-932

ISSN (E): 2277- 7695

ISSN (P): 2349-8242
NAAS Rating: 5.23 Surgical management of umbilical hernia in a buffalo
TPI 2021; SP-10(7): 929-932
© 2021 TPI bull calf: A case report
www.thepharmajournal.com
Received: 12-05-2021
Accepted: 19-06-2021
Athira B George, Ayisha VK, Praveen PU, Sonaa M, Sreelakshmi SS,
Athira B George Deepak Chandran and Athira Rajan
Veterinary Doctor (BVSc & AH),
Kerala, India Abstract
An organ or tissue protrudes through an opening in the body wall, causing a hernia. A tear in the
Ayisha VK
Veterinary Doctor (BVSc & AH), abdomen wall or diaphragm may cause the aperture, or it may be a natural opening such as the inguinal
Kerala, India canal or femoral canal. The protruded tissue is covered by the skin, unlike in a prolapse. A typical hernia
has a hernial ring and a hernial sac through which the contents have migrated. The neck, body, and
Praveen PU fundus make up the hernial sac, which encloses the hernial contents. A 3-month-old cross-bred buffalo
Veterinary Doctor (BVSc & AH), bull calf was brought with a history of swelling in the umbilical region. Upon physical examination, the
Kerala, India condition was diagnosed as umbilical hernia. The umbilical hernia was reduced and corrected by
performing herniorrhaphy. The animal had an uneventful recovery.
Sonaa M
Veterinary Doctor (BVSc & AH), Keywords: Hernia, buffalo bull, umbilical, herniorrhaphy
Kerala, India

Sreelakshmi SS
Introduction
Veterinary Doctor (BVSc & AH), An organ or tissue protrudes through an opening, which can be created by a tear in the
Kerala, India abdominal wall or diaphragm, or it might be a natural hole such as the inguinal or femoral
canal. A typical hernia has a hernial ring and a hernial sac through which the contents have
Deepak Chandran migrated. The neck, body, and fundus make up the hernial sac, which encloses the hernial
Assistant Professor, Department
of Veterinary Sciences and contents. The hernial contents are frequently made up of portions of visceral organs such as
Animal Husbandry, School of the intestines, omentum, liver, spleen, urinary bladder and uterus (Angus and Young, 1972;
Agricultural Sciences, Amrita Venugopalan, 2000) [1, 13]. Umbilical hernia is common in calves but uncommon in lambs and
Vishwa Vidyapeetham children. Females are more likely than males to develop the illness. With a 4-15 percent
University, Coimbatore, Tamil prevalence, it is one of the most common surgical pathologies in crossbred calves. Congenital
Nadu, India
or acquired umbilical hernias are also possible. A few weeks after delivery, an acquired hernia
Athira Rajan is discovered. Umbilical hernia can be caused by inherited causes such as low-penetrance
Veterinary Doctor (BVSc & AH), dominant genes, autosomal recessive genes, or environmental factors (Brem et al., 1985) [2]. In
Kerala, India herniation, changes in the function of both the body cavity and the herniated contents might be
significant. These alterations may appear small, but they can have profound
pathophysiological effects, leading to acute severe sickness and, in extreme cases, death.
These alterations may appear small, but they can have profound pathophysiological
repercussions that can result in acute severe sickness and, in some cases, animal death (Hayes,
1974) [4]. The Urachus and Umbilical blood vessels can pass through the umbilical hole in the
foetus. These structures are disrupted or severed at the time of birth, and the umbilical hole
closes around the cord. The wound heals through cicatrization and later on represents the
umbilicus. A defect may remain in the mid ventral line due to inappropriate closure due to
developmental abnormalities and/or hypoplasia of abdominal muscles, resulting in a
congenital hernial ring. Manual breaking or sectioning of the cord excessively close to the
abdominal wall, as well as excessive straining from diarrhoea, constipation, and other causes,
hinder the umbilical aperture from closing properly, which can lead to umbilical hernia
(Knecht et al., 1987) [5]. Umbilical hernia can be treated in a variety of ways, both conservative
Corresponding Author and surgical. Only minor reducible hernias are suitable for conservative therapies. The hernial
Deepak Chandran ring can be closed using conservative treatments such as belly bandages/ abdominal bandages,
Assistant Professor, Department injections, or the application of irritants around the hernial ring. When the hernia is big and
of Veterinary Sciences and
Animal Husbandry, School of unreducible, radical surgery is required (Kumar and Amresh, 1996) [6].
Agricultural Sciences, Amrita
Vishwa Vidyapeetham 2. Materials and Methods
University, Coimbatore, Tamil A cross-bred buffalo bull calf aged 3 months (Figure 1) was presented with a swelling on the
Nadu, India
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umbilical region (Figure 2), which was said to have been lateral recumbency & ventral abdomen was prepared for
present since birth. The animal was active and alert. Feed and aseptic surgery. Mid ventral site was selected.
water intake, plus urination and defaecation was normal. No
other abnormalities could be detected. Upon clinical
examination, temperature was found to be 100.40 F, mucus
membrane was brick red, respiration rate was 20 per minute
and lymph nodes were palpable. Upon physical examination,
Animal was quite active and alert. On examination of the
swelling, soft elastic fluctuating mass and the hernia ring
could be easily felt. The hernia contents were reducible and
inflammatory signs were not detected. The condition was
therefore diagnosed to be umbilical hernia and the surgical
correction via herniorrhaphy using nylon was advised. The
animal was fasted for 24 hours prior to the surgery. The
animal was analgesised using Xylazine @ 0.1 mg/kg body
weight as i/m. Pre-operative anaesthesia was given as
Meloxicam @ 0.4 mg/kg body weight as i/m, Cefotriaxone @
10 mg/kg body weight as i/m, multi-vitamin injection @ 3ml Fig 1: Animal brought for surgery
as i/m and Ringer Lactate as i/v. The patient was placed on

Fig 2: Herniated M ass

Surgical Technique elliptical fashion. Subcutaneous tissue was opposed using

Since the animal was male, the prepuce, preputial PGA size 1-0 in subcutaneous suture pattern. Skin was closed
diverticulum, and penis was reflected to one side. After with monofilament nylon in horizontal mattress pattern. A
aseptical preparation of the surgical site, xylazine gauze stent was fixed over the suture line and applied
hydrochloride @ 0.1mg/kg body weight as i/m and 2% Tincture Benzoin. A course of antibiotic (Ceftrizone as i/v),
lignocaine was infiltrated locally at operative site. After NSAID (Meloxicam 5ml as i/m) and multi-vitamin injection
proper analgesia, an elliptical incision was made exactly on (Tribivet 4ml as i/m) were administered for a period of 3
the swelling avoiding blood vessels and umbilicus. By blunt days. Daily dressing of the wound was done using Betadine
dissection muscles and peritoneum were separated. Intestines ointment. The owner was advised to feed only soft and fluidy
were found as hernia contents. There were no adhesions and diet for over 1 week and had to be kept as quiet as possible for
contents were replaced into the abdominal cavity. Washed the two weeks until recovery. An abdominal bandage was advised
abdominal cavity with Metrogyl and Normal Saline. The to be put over the abdomen for few days to hasten the healing
hernial ring edges were freshened and was closed by far near process, by reducing the pressure on the ventral aspect of the
far and horizontal mattress suture pattern using prolene size 1- abdomen. The images with regard to conduct of surgery were
0. Excess skin was resected till the neck of the sac is in an shown as Figure 3.

A B

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C
Fig 3: (A) Exposing hernial sac (B) Hernial content + incised sac (C) Suturing of ring using prolene 1-0

3. Results and Discussion hernia is modest in small animals, surgical repair is frequently
Following herniorrhaphy, the bull calf showed an uneventful done at the same time as sterilising operations. Applying a
recovery. The animal was well managed by the owner. The large adhesive bandage (10 cm width) on calves for 3–4
skin sutures were removed on the 10th day. weeks has shown some success. Manual breaking or
An organ or tissue protrudes through an opening in the body sectioning of the cord excessively close to the abdominal
wall, causing a hernia. A tear in the abdomen wall or wall, as well as excessive straining from diarrhoea,
diaphragm may cause the aperture, or it may be a natural constipation, and other causes, hinder the umbilical aperture
opening such as the inguinal canal or femoral canal (Hayes, from closing properly, which can lead to umbilical hernia
1974) [4]. The protruded tissue is covered by the skin, unlike (Rahman et al., 2011) [8]. Umbilical hernia can be treated in a
in a prolapse. A typical hernia has a hernial ring and a hernial variety of ways, both conservative and surgical. Only minor
sac through which the contents have migrated. The hernial sac reducible hernias are suitable for conservative therapies. The
is made up of the neck, body, and fundus, and it encloses the hernial ring can be closed using conservative treatments such
hernia contents. The neck refers to the area of the hernia sac as belly bandages/ abdominal bandages, injections, or the
closest to the hernia ring, the fundus to the lower portion, and application of irritants around the hernial ring. When the
the body to the area between the fundus and the neck (Kumar hernia is big and unreducible, radical surgery is required.
and Amresh, 1996) [6]. The parietal peritoneum creates the
hernia sac. Correction of umbilical hernia
Reduction and retention by bandage: The hernia is reduced by
Etiology local manipulation and bandage is applied around the
Predisposing factors include incomplete closure of an abdomen to prevent its return. An ‘elastoplast’ bandage is
embryonic defect or abdominal wall weakness due to better to avoid interference with breathing. The bandage is
contusion, local inflammation, and other factors. Increased retained for two to three weeks.
intra-abdominal pressure from constipation, diarrhoea, violent Application of blisters or injection of irritant solutions: This
coughing, gastric/intestinal tympany, during parturition, or procedure done close to the hernial ring after reducing the
direct violence from falling on a blunt object are all exciting hernia causes inflammatory swelling which is sometimes
causes (Williams, 2012) [14]. Umbilical, inguinal, and scrotal sufficient to prevent recurrence of small hernia and to
hernias all affect the abdominal wall. Umbilical hernias occur facilitate closure of the hernial orifice.
when the umbilical ring fails to close properly, allowing Ligature or hernial clamp: a hernial clamp or through-and-
abdominal contents to protrude into the underlying subcutis through mattress sutures may be applied at the base of the
(Fubini and Ducharme, 2004) [3]. The degree of the umbilical hernial sac after reducing the hernia to facilitate the sloughing
defect and the amount of abdominal contents enclosed within off of the sac and simultaneous closure of the hernial ring.
it determine the size. In both large and small animals, the Radical operation for hernia: Incisions are made in the hernial
aetiology is believed to be genetic; however, alternative sac in an elliptical or linear pattern (If the peritoneal sac is
reasons include excessive traction on an enormous foetus or present it is separated from the neck by blunt dissection and
cutting the umbilical cord too close to the abdominal wall. incise through peritoneum). The hernial ring is used to restore
The diagnosis is usually simple, especially if the hernia can be the contents of the hernia (Venugopalan, 2000) [13]. The
reduced easily. The hernia must be distinguished from an hernial sac's neck is ligatured, and the stump is forced through
umbilical abscess, which is prevalent in large animals, if it is the hernial ring. The hernial ring's boundaries are then
irreducible (Samad et al., 2002) [9]. In cattle and swine, freshened, sutured together, and closed (Sharma, 2003) [10].
umbilical hernia and umbilical abscess are frequently Herniorrhaphy is the suturing of the hernial ring. Suturing is
observed simultaneously. For confirmation, an exploratory made easier by removing a triangular portion of tissue from
puncture, such as a fine-needle biopsy with cytopathology, either end and transforming it to an elliptical shape if the
may be required. Correction is a surgical procedure. If the hernial ring is circular. When closing the hernial opening,

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‘double breasting' is sometimes favoured. This is Philadelphia 2004, 237p.

accomplished by suturing the superficial and deep muscle 4. Hayes HM. Congenital umbilical and inguinal hernias in
sheaths of the Rectus abdominis muscle in such a way that the cattle, horses, swine, dogs and cats: Risk by breed and
muscular bellies of both sides slightly overlap at this point. sex among hospital patients. Am. J. Vet. Res
Overlapping sutures are another way to repair the hernial ring. 1974;35:839-842.
It is impossible to suture the borders of a hernial ring if it is 5. Knecht CD, Allen AR, Williams DJ, Johnson JH. Suture
too large. In such circumstances, hernioplasty is performed by materials and suture patterns. In: Fundamental
suturing fascia lata or stainless-steel wire mesh to the margins Techniques in Veterinary Surgery (3rd Ed). W.B.
and closing the space with it (Sutradhar et al., 2009) [12]. After Saunders Company, Philadelphia 1987, 28-73.
suturing the skin margins and eliminating any extra skin, the 6. Kumar, Amresh. Veterinary Surgical Techniques (1st Ed).
hernial ring is closed. UBS Publishers Distributors, Ltd, New Delhi 1996, 310-
312.
Herniorrhaphy 7. Kumar V, Kumar N, Gangwar AK, Saxena AC. Using
 In the present case, the animal had a large umbilical acellular aortic matrix to repair umbilical hernias of
hernia which was simple in nature. The hernial ring was calves. Aust. Vet. J 2013;91:251-253.
large and rounded. The intestinal contents were 8. Rahman MM, Biswas D, Hossain MA. Occurrence of
protruding into the hernial sac. Herniorrhaphy could be umbilical hernia and comparative efficacy of different
performed easily as the contents were not strangulated or suture material and techniques for its correction in calves.
incarcerated. Local, epidural or general anaesthesia may Pakistan. J. Bio. Sc 2001;4:1026-1028.
be used and the animal could be placed in lateral or 9. Samad MA, Islam MA, Hossain MA. Patterns of
dorsal recumbency. As it was difficult in reducing the occurrence of calf diseases in the district of Mymensingh
contents back into the abdomen when placed in the lateral in Bangladesh. Bangladesh. Vet. J 2002;36:01-05.
recumbency and also due to the ruminal gas distension, 10. Sharma A. Passage of abdominal viscera through
animal was restrained in the dorsal recumbency. The persistent umbilical opening in a newly born female
animal was approached ventrally and a long incision was buffalo calf and its surgical correction. Intas Polivet
made longitudinally on the hernia. Thus, incision had to 2003;4:335-336.
be placed over the hernia longitudinally. After placing the 11. Sushanta Srivastava. Congenital Anomalies and their
incision, the contents of the hernia was pushed back into Surgical Correction in Ruminants. Adv. Anim. Vet. Sc
the abdomen. The ring was then differentiated and it was 2007;2:369-376.
freshened using the scalpel blade. The edges were then 12. Sutradhar BC, Hossain M, Das BC, Kim G, Hossain MA.
sutured using size 1-0 prolene by overlapping vertical Comparison between open and closed methods of
mattress sutures (Rahman et al. 2001) [8] and far near near herniorrhaphy in calves affected with umbilical hernia. J.
far sutures. Excess skin was then resected close to the Vet. Sci 2009;10:343-347.
body. Size 1-0 Relyon PGA was used to put 13. Venugopalan A. Essentials of Veterinary Surgery (8th
subcutaneous sutures to avoid dead space. Skin was then edn). Oxford and IBH Publishing Co. Pvt. Ltd, New
closed using Nylon. A tincture benzoin pad of cotton was Delhi 2000, 273-281.
applied over the suture line. Intensive post-operative care 14. Williams HJ, Gillespie AV, Oultram JW, Cripps PJ,
along with antibiotic therapy was employed. On the 10th Holman AN. Outcome of surgical treatment for umbilical
post-operative day, stitches were removed and uneventful swellings in bovine youngstock. Vet. rec 2012;9:126.
recovery was noticed. Sushanta (2007) [11] and Sutradhar
et al. (2009) [12] suggested closed herniorrhaphy to be
better than the commonly used open method for the
correction of reducible umbilical hernia in calves. They
also suggested that incidence of umbilical hernia is more
on case of female claves than the male calves.

4, Conclusion
In this present case, the animal had a large umbilical hernia
which was simple in nature. The hernial ring was large and
rounded. The intestinal contents were protruding into the
hernial sac. The umbilical hernia was reduced and corrected
by performing herniorrhaphy. Herniorrhaphy could be
performed easily as the contents were not strangulated or
incarcerated. The animal had an uneventful recovery.

5. References
1. Angus K, Young GB. A note on genetics of umbilical
hernia. Vet. Rec 1972;90:124-126.
2. Brem G, Hondele J, Distl O, Hrausslich H. Investigation
of the occurrence and causes of umbilical hernia in
German brown calves. Tierarztl. Umschau 1985;40:877-
882.
3. Fubini SL, Ducharme NG. Surgery of abomasums. In:
Farm Animal Surgery (1st Ed.). W.B. Saunders Company,

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