Traumatic Abdominal Wall Rupture in Cats: Diagnosis & Management

In the Literature

Hennet JM, Williams J. Traumatic abdominal wall rupture in cats: decision-making and recommended repair techniques. J Feline Med Surg. 2021;23(3):234-240.

The Research …

Rupture of the abdominal wall in cats is relatively uncommon and typically the result of trauma that causes damage to abdominal viscera, perforation of the abdominal wall, and potential injuries to other anatomic areas. 

This study describes a logical, comprehensive approach for management of traumatic abdominal wall rupture in cats in which evaluation and management should focus on assessment of internal injuries and stabilization. The entire cat should be examined for possible accompanying injuries of the limbs, thorax, head, and neck. Surgical repair is typically delayed until the patient is sufficiently stable to tolerate general anesthesia. Exceptions may include patients with internal organ injury, with extensive abdominal contamination, or that cannot be stabilized due to displaced viscera. 

Disruption of the abdominal wall can be diagnosed through physical examination, but imaging (eg, radiography, ultrasonography) is also often required. 

Surgical repair typically involves preplacement of monofilament absorbable or nonabsorbable sutures in an interrupted pattern. A tension-relieving suture pattern (eg, horizontal mattress) is commonly preferred. Because the abdominal defect often does not include structures with high connective tissue content, the defect is repaired by closing muscle layers; secure suture placement should be ensured. Synthetic mesh or muscle flaps may be needed to close the defect during repair of chronic abdominal wall rupture or if trauma has destroyed available local tissue. Muscle flaps are typically preferred due to the potential for complications (eg, infection, dehiscence, seroma) associated with synthetic mesh.

… The Takeaways

Key pearls to put into practice:

• Systemic stabilization should be the highest priority in cats with acute injuries. Viscera displaced from the abdominal cavity can often be gently relocated and held in place, at least temporarily, with external bandages.

• Diagnosis of traumatic abdominal wall rupture in cats, particularly in those with chronic rupture, may require imaging.

• Repair of the defect can typically be achieved using local tissues. Transposition of muscle flaps or use of synthetic mesh may be required for larger defects.