Equine Clinic De Morette Asse, Vlaams-Brabant, Belgium
Nonsurgical Manual Reduction of Indirect Inguinal Hernias in 89 Adult Stallions. Baranková K1, de Bont M2, Simon O3, Meulyzer M4, Boussauw B1, Vandenberghe F1, Wilderjans H1. 1Equine Clinic De Bosdreef, Moerbeke-Waas, Belgium; 2Dubai Camel Hospital, Dubai, United Arab Emirates; 3University of Adelaide, Adelaide, Australia; 4Equine Clinic De Morette, Asse, Belgium.
The outcome following reduction of Indirect Inguinal Hernia (IIH) utilizing a manual reduction (MR) technique in a large number of horses has not been previously reported. The objective of this study was to describe an MR technique developed by the authors and to report the long-term experiences and clinical outcome. Medical records of 89 stallions presenting with IIH and treated with MR were reviewed. Extensive patient data was collected, with cases grouped based on outcome of the MR procedure and whether or not laparotomy was performed. Data on short- and long-term outcome was obtained. Manual reduction successfully reduced the IIH in 80/89 (90%) of horses. Fifty of 89 (56%) horses were treated with MR only and without exploratory laparotomy. In total 29/89 (33%) underwent immediate ventral midline laparotomy and 10/89 (11%) delayed ventral midline laparotomy (DVML). Resections were performed in 6/89 (8%) horses. Concurrent small intestinal volvulus was diagnosed in 8/89 (9%) horses. Horses undergoing DVML following a successful MR had the highest mortality rates during hospitalization (4/10, 40%). Short-term survival was 92% (82/89). Long-term survival with a mean of 12 years was 72% (34/47). The main limitations of this study are its retrospective nature, lack of in-hospital recording of preoperative assessment data, and a biased population of mainly Warmbloods. Manual reduction appears to be a feasible technique to reduce IIH in adult Warmblood horses, with favorable survival rates. Individual case assessment is crucial, as delayed laparotomy may increase mortality rates.