Ventral Hernia [Hysterocele - Gravid] in a goat (Video Supported)

The 3-year-old multiparous pregnant goat illustrated seen at left is presented to Department of Surgery and Obstetrics with a rapidly enlarging udder. The owner is concerned about the abrupt development of an extensive area of painful oedema on the udder. She has last covering date of parturition and has exhibited increasing depression and discomfort during the previous 24 hours. Physical examination found a presenting foetus with head and legs inside the udder, the foetus moved vigorously when touched, when goat was placed dorsally the foetus returned back to abdomen. Ultrasound examination of the enlarging udder showed the fluid and foetus with normal heart beats. Over the next half hour, the gaot's heart rate increased and respiratory efforts became more laboured with further signs of developing depression. Initial treatment for ventral ruptures is aimed at stabilising the goat by restricting activity. It is important to closely monitor for signs of blood loss, constipation, loss of protein and any development of further discomfort. Anti-inflammatory drugs may help relieve the discomfort. A laxative, high concentrate diet may assist in decreasing the bowel contents and reducing the degree of abdominal exertion associated with defecation. The possibility of bowel entrapment and strangulation should be investigated and surgical correction performed where appropriate. In many cases, due to rapidly changing clinical parameters, the goat gains little from supportive treatment and induction of parturition (or termination of the pregnancy in goats earlier in gestation) must be performed. Assistance with parturition is always necessary as the goat is likely to experience difficulty in inducing sufficient abdominal pressure to deliver the fetus. If the fetus is sufficiently mature, the kid will generally progress well after induction of parturition.

Surgical Treatment

Food was withheld for 24 h prior to surgery. Surgical repair was conducted by aseptically preparing the site of operation after intramuscularly tranquilizing the fractious animals with 2% xylazine hydrochloride (Rompun 2%; Bayer, Turkey) at a dose rate of 0.05 mg/kg. Circular infiltration anesthesia around the udder was done using 2% lidocaine (Norbrook Laboratories, UK) at a dose rate of 10 mg/kg. The animal was restrained in the dorsal or lateral recumbent position, according to the ease and for better exposure. An elliptical skin incision was performed and uterus exteriorized and tree kids were removed. Uterus was closed with 2/0 chromic catgut with Connell suture technique. The contents were reduced into the abdominal cavity through abdominal rupture. The abdominal rupture was exposed and closed with simple interrupted uing No. 2 chromic catgut (Ethicon, UK). The subcutaneous tissue was then sutured by catgut and the skin was closed with using silk suture. Penicillinstreptomycin at a dose rate of 30,000 IU/kg for the penicillin and 10mg/kg streptomycin was given for 5 days intramuscularly.

The Video Support for the case is as Under:

Reception of the Case, History Taking, Ultrasonography, Surgery Started:

Surgery continued:

Continued..., Surgery Completed, Patient is on her legs and very much normal:

Interview of the Surgeon Dr. Allah Bux Memon, after the completion of Surgery:

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