A Hole in the Wall

December 5, 2012

Yesterday I performed an umbilical hernia repair on an incredibly cute French Bulldog. The surgery went smoothly, but it was more than a cosmetic repair in this case. This young dog was born with the hernia, but recently the hernia went from being small and soft, to large, firm and bright red. One of my colleagues saw Frenchie as an appointment since the hernia had changed in size, and strongly urged that the dog undergo surgery to repair the defect.

Umbilical hernias are relatively common congenital defects, where the abdominal wall does not close completely in the area where the umbilical cord was attached. Often, these hernias are reducible, which means they are small, soft swellings which can be temporarily pushed back into the abdomen. Inevitably, the hernia recurs after being reduced. In most cases, hernias like these are easily repaired at the time of spay or neuter surgery, and do not cause any problems for the dog. Umbilical hernias occur frequently in small and toy breed dogs; they are considered a heritable defect, so animals with umbilical hernias should not be bred, as their offspring are likely to have the same problem. (People can also be born with umbilical hernias.)

In some instances, as was the case with Frenchie, tissue can be come entrapped, or strangulated within the hernia. This is particularly a concern if a loop of intestine becomes trapped within the hernia sac. If the intestine cannot be reduced back into the abdomen, it quickly can become painful, necrotic and require emergency surgery where part of the intestine may need to be removed. Fortunately, this is an uncommon occurrence. In Frenchie’s case, two segments of fat were trapped within the hernia; these pieces of fat were black and necrotic. The area under Frenchie’s skin, known as the subcutis, was angry and inflamed.

Fortunately, no intestinal contents were discovered in the hernia. I was able to cut off the unhappy fat, and close the abdominal wall with suture material, as well as remove some of the inflamed subcutaneous tissue. Frenchie should have a full recovery. And now he’s as cute as ever!