Patient: Cadence, weanling filly

Presenting complaint: umbilical hernia- suddenly swollen

Cadence was presented to Willamette Valley Equine for evaluation of an umbilical hernia that has been present since shortly after birth. The hernia was a small, "1 finger" hernia, but the previous day it had become swollen, painful to the touch and non-reducible. Cadence had surgery to repair the hernia the next day. The hernial sac had a piece of small intestine adhered to it, causing what is known as a parietal, or Richter's hernia. The bowel was damaged and impacted with feed and had to be removed. Cadence recovered well from surgery.

Umbilical hernias result from failure of the body wall to close after the umbilical cord remnant recedes several weeks after birth. These hernias look and feel like a soft bubble where the umbilical cord used to be. The hernia should be reducible, meaning that you can push the contents out of the sac back into the abdomen with your hand. Hernias can be small, only 1/2 to 1 inch across, or much larger. Many umbilical hernias will close as the foal ages. However, as they close, sometimes they can entrap intestine, causing serious problems, as in Cadence's case. Also, many hernias especially larger ones, never close completely and need to be repaired surgically.

All foals with umbilical hernias should be monitored closely, and the hernia palpated and reduced daily until spontaneous closure or surgical repair. Any hernia that suddenly becomes hard, swollen, or painful, is an emergency, because intestine could be entrapped in the hernia. If the intestine is left in the hernia, it will eventually die and cause either an abscess, a fistula from the intestine to outside or the body (enterocutaneous fistula), or worse of all it can rupture into the abdomen causing fecal contamination of the abdomen, and death.