Monday, March 7, 2016

Post-op complications after umbilical hernia repair

The swelling appeared around 10 days after an inguinal hernia repair by Dr Daniel who was now in Vietnam.

The young couple WhatsApp the image on Feb 26, 2016   "Hi, my dog jux went for the hernia ops at the tummy wif ur vet and the plaster drop off a while alrdy den the tummy starts dropping like dat. Is it OK?"

I replied: "Pl bring in for check up tmrow" in an inexpert way of texting unlike the younger generation. 

At the consultation, I said: "It could be a blood collection called a haematoma or a hernia due to a stitch breakdown. These are post-op complications due to the dog being too active and not confined to a small area."

Apparently Dr Daniel did not give such instructions to confine the dog in a small area and so the dog had this large swelling. I told the owner that the vet was in Vietnam and so he could not reply. Post-operation complications do occur as the dog is very active.

"He could have licked the wound," I said.
"No," the owners said. "He had worn a large E-collar."
"There are bruised purplish areas towards the end of the stitching nearer the tail area," I said. "This is evidence of the e-collar's edges traumatising the skin."

The dog was anaesthesized and over 300 ml of unclotted blood was taken out by syringe.

This unclotted blood showed that bleeding was recent, probably yesterday. The stitches did not break down and so there was no umbilical hernia.

Evidence of the bruised area is important. The dog had been hitting the back area of the wound, damaging the subcutaneous blood vessels, leaking blood under the skin, causing a large swelling which the couple thought was bigger than the original hernia.


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