Perioperative management of umbilical herniorrhaphy with ileal resection and anastomosis in a pygmy hippopotamus (Choeropsis liberiensis)

A 28-year-old 278 kg female pygmy hippopotamus (Choeropsis liberiensis) with a chronic, static umbilical hernia presented acutely for lethargy and anorexia. Ultrasonography and abdominocentesis were consistent with an incarcerated umbilical hernia. An exploratory laparotomy, ileal resection and anastomosis, and herniorrhaphy were carried out via a ventral midline incision and the hippopotamus remained hospitalised for 9 weeks postoperatively. A second surgery was necessary to debride the incision site after the primary skin closure dehisced. Improved support to skin sutures was provided using sterilised plastic cable zip ties, which were better suited to the unique skin of the hippopotamus and tension associated with the animal's size and anatomy. Incisional closure is a recognised challenge in this species and significant reinforcement is required to prevent wound dehiscence. The novel use of cable zip ties provided stability where suture material had transected the incision and should be considered in hippopotamus surgery.