A unique case of traumatic pelvic hernia in a Pomeranian

Abstract

Case Description: A 2-year-old castrated male Pomeranian was evaluated for traumatic pelvic factures and luxations and an equivocal ventral abdominal body wall hernia presumed to be the result of cranial pubic ligament avulsion. Clinical Findings: Pre-operative imaging confirmed the presence of herniated abdominal contents through the cranioventral pelvic inlet, through the right obturator foramen, and into the deep fascial planes of the right hind limb. Treatment and Outcome: A standard laparotomy was performed, the defect explored, and the cranial pubic ligament was deemed intact. A soft-tissue defect was observed in the pubovesical pouch lateral to the median ligament of the bladder, through which passed herniated abdominal contents. Approximately 18 inches of jejunum and omentum were reduced from the hernia. The defect was closed by apposing the tissue fragments together as well as to the seromuscular layer of the ventral pelvic urethra. After consecutive surgeries to correct his fractures and luxations, the patient recovered with no indication of gastrointestinal complications or re-herniation. A cadaver dissection performed later confirmed that the right levator ani, internal obturator, and external obturator muscles had become stretched or avulsed in order to create the hernia in question. Clinical Relevance: No reports of pelvic hernia of this kind could be found in the literature. The biomechanics of the patient’s injury and the relevant pelvic musculoskeletal anatomy are a potent reminder that although many surgeons consider the abdomen, the pelvic canal, and the hind limb to be clinically distinct regions of the body, it is important to understand the anatomical communications and relationship among them.