1. Introduction
Omphalophlebitis is a pervasive and deleterious pathology encompassing a broad age span of foals or calves.1-4 Left undiagnosed, omphalophlebitis frequently results in fatal secondary complications, such as septic arthritis, physitis, pneumonia, diarrhea, intraabdominal adhesions, and/or septicemia.1,3-7Treatment options involve broad-spectrum antimicrobial therapy which may be combined with umbilical remnant excision.1,3,6-9Surgical excision reportedly enhances survival rates compared to antimicrobial treatment alone.6,7
Umbilical remnant excision has been documented employing ventral celiotomy or laparoscopy.2,5-7,10,11 Omphalophlebitis cases with liver involvement carry a poorer prognosis, with up to 50% mortality.1,6,8,12 Umbilical vein marsupialization is advocated to promote drainage when complete resection cannot be attained by ventral midline celiotomy or laparoscopy.1,5,6-9,13,14
A one stage or two stage procedure for umbilical vein marsupialization have been described in foals and calves.8,9,13,15-18In one-stage marsupialization, the umbilical arteries and urachus are routinely resected prior to paramedian translocation of the umbilical vein through a separate incision to the right of midline.8,13-18 Two-stage marsupialization incorporates the umbilical vein into the cranial aspect of the incision and a second procedure is required to remove the umbilical vein remnant and close the remaining body wall defect.9,13,15,19Advantages and disadvantages of both techniques have been reported, such as cellulitis at the marsupialization site.8,9,13-15,17-19 In one report, 46% of calves developed a hernia at the marsupialization site.14Currently, there are no reports detailing hernia development following one stage marsupialization of the umbilical vein in foals. This report describes hernia formation in three foals following one stage umbilical vein marsupialization for extensive omphalophlebitis.