Analyze Diet

Topic:Surgery

Surgery for horses encompasses a range of procedures performed to diagnose, treat, or manage various medical conditions. These procedures may involve soft tissue or orthopedic interventions and require specialized techniques to accommodate the unique anatomical and physiological characteristics of equines. Common surgical procedures in horses include colic surgery, fracture repair, and arthroscopy. The success of equine surgery depends on numerous factors, including the type of procedure, the horse's overall health, and post-operative care. This page compiles peer-reviewed research studies and scholarly articles that explore surgical techniques, outcomes, and advancements in equine surgical practices.
Umbilical Cord Herniation With Small Intestinal Evisceration in Two Thoroughbred Neonates.
Journal of equine veterinary science    April 14, 2022   Volume 114 103959 doi: 10.1016/j.jevs.2022.103959
Gough R, McGovern K, Bladon B, De Oliveira F.This report describes two cases of spontaneous small intestinal evisceration via normally inserted umbilical stumps, without abdominal wall trauma. Both cases occurred immediately following uneventful parturition. The authors believe that these represent cases of umbilical cord herniation. This is a well-recognised condition in humans, but has not been previously described in equines. One foal died before veterinary intervention. The second foal underwent a jejunal resection with end-to-end anastomosis and survived to successfully race. This report describes a previously unrecognised condition...
Arthroscopic removal of palmar intermediate carpal bone fracture fragments in four horses using a transthecal approach through the carpal flexor tendon sheath.
Veterinary surgery : VS    April 11, 2022   Volume 51, Issue 6 929-939 doi: 10.1111/vsu.13813
Hewitt-Dedman CL, O'Neill HD, Bladon BM.To describe the removal of palmar intermediate carpal bone (ICB) fracture fragments using a transthecal approach through the carpal flexor tendon sheath. Methods: Case series. Methods: Four horses with fractures of the palmar aspect of the ICB. Methods: Two horses were injured when falling and two during recovery from general anesthesia. Three horses underwent MRI to supplement conventional imaging. Three horses had concurrent fractures of the radial and/or accessory carpal bones. Conventional proximolateral carpal sheath arthroscope and instrument portals were used, supplemented with a medial...
Influence of Butorphanol, Buprenorphine and Levomethadone on Sedation Quality and Postoperative Analgesia in Horses Undergoing Cheek Tooth Extraction.
Veterinary sciences    April 6, 2022   Volume 9, Issue 4 doi: 10.3390/vetsci9040174
Emanuel D, Kästner SBR, Delarocque J, Grob AJ, Bienert-Zeit A.The aim of this prospective clinical trial was to compare the influence of butorphanol, buprenorphine and levomethadone on sedation quality and postoperative analgesia in horses undergoing cheek tooth extraction. Fifty horses were assigned to three groups prior to oral cheek tooth extraction. Horses were treated with acepromazine, followed by a detomidine bolus, one of the three opioids and both a nerve block and gingival anaesthesia. During the surgery, sedation was maintained with a detomidine constant rate infusion. After surgery, the quality of sedation, surgical conditions and severity of...
Packed cell volume and heart rate to predict medical and surgical cases and their short-term survival in horses with gastrointestinal-induced colic.
The Canadian veterinary journal = La revue veterinaire canadienne    April 5, 2022   Volume 63, Issue 4 365-372 
Kos VK, Kramaric P, Brloznik M.The objective of this prospective case-control study of 125 horses with gastrointestinal tract-induced colic was to determine whether heart rate (HR) and packed cell volume (PCV) can predict surgical medical treatment and its short-term survival (time of discharge of the patient). Sixty-four horses were treated medically and 61 surgically (29 small intestinal and 32 large intestinal cases). At admission, both PCV and HR were higher in horses treated surgically than in horses treated medically; however, with longer duration of colic before presentation, the PCV was higher in the small intestin...
Multi-modality imaging of aggressive submural neoplasia of the hoof in two horses.
Australian veterinary journal    April 5, 2022   Volume 100, Issue 7 336-341 doi: 10.1111/avj.13161
Nagel H, Lang H, Sole Guitart A, Lean N, Allavena R, Sprohnle-Barrera C, Young A.This case series presents a 20-year-old Quarter horse gelding and a 10-year-old Thoroughbred gelding with a histologic diagnosis of aggressive submural neoplasia, including an anaplastic sarcoma and a squamous cell carcinoma respectively. The current case series describes these neoplasias with radiography, computed tomography, magnetic resonance imaging and histopathology with immunohistochemistry. The purpose of this case series is to identify the clinical pattern of chronic reoccurring lameness in these cases and highlight the appearance of expansile osteolytic pathology of the distal phalan...
Current use of biologic therapies for musculoskeletal disease: A survey of board-certified equine specialists.
Veterinary surgery : VS    April 5, 2022   Volume 51, Issue 4 557-567 doi: 10.1111/vsu.13805
Knott LE, Fonseca-Martinez BA, O'Connor AM, Goodrich LR, McIlwraith CW, Colbath AC.To evaluate the use of mesenchymal stem cells (MSCs), autologous conditioned serum (ACS), platelet-rich plasma (PRP), and autologous protein solution (APS) for the treatment of equine musculoskeletal disease by diplomates of the American College of Veterinary Surgery (ACVS), and American College of Veterinary Sports Medicine and Rehabilitation (ACVSMR). Methods: Cross-sectional study. Methods: Diplomates (n = 423). Methods: An email link was sent to ACVS and ACVMR diplomates. A survey contained 59 questions regarding demographics, as well as indications, frequency, adverse effects, and limit...
Three-Dimensional Modeling and In Silico Kinematic Evaluation of Interspinous Ligament Desmotomy in Horses.
Frontiers in bioengineering and biotechnology    April 1, 2022   Volume 10 817300 doi: 10.3389/fbioe.2022.817300
Biedrzycki AH, Elane GL. Interspinous ligament desmotomy (ISLD) has been shown to improve the comfort of horses diagnosed with overriding dorsal spinous processes (DSP), but its effects on spine mobility are unknown. To objectively quantify the change in mobility of thoracic vertebrae following ISLD using CT and medical modeling software. Prospective cadaveric manipulation of seven equine thoracolumbar spines collected from T11-L1. Spines were collected from T11-L1 with the musculature intact. Flexion and extension phases were achieved with a ratchet device calibrated to 2000N. Bone volume CT scans were performed ...
Plantar osteochondral fragments in young Standardbreds are associated with minimal joint inflammation at the time of surgical removal.
Equine veterinary journal    March 29, 2022   Volume 55, Issue 1 33-41 doi: 10.1111/evj.13575
McCoy AM, Secor EJ, Roady PJ, Gray SM, Klein J, Gutierrez-Nibeyro SD.Plantar osteochondral fragments (POF) are common but their effect on joint health of young Standardbreds in race training is largely unknown. Objective: Evaluate the inflammatory effects of POF in metatarsophalangeal joints of young Standardbreds as a step towards developing evidence-based recommendations for surgical removal. Methods: Cohort study. Methods: Forty-nine Standardbred horses (age 11-33 months) presented for surgical removal of POF from 56 metatarsophalangeal joints. Synovial tissue collected at arthroscopy was subjected to histopathology. IL-1β, TNF-α, and PGE-2 were measured ...
Perioperative lung ultrasonography in healthy horses undergoing general anesthesia for elective surgery.
Journal of veterinary internal medicine    March 24, 2022   Volume 36, Issue 3 1160-1172 doi: 10.1111/jvim.16408
Ribonnet C, Palmers K, Saegerman C, Vanderperren K, van Galen G.Lung ultrasound (LUS) is poorly evaluated in horses, especially perioperatively. Objective: (1) Describe LUS findings in healthy horses before and after general anesthesia (GA), (2) evaluate if GA induces ultrasonographic changes in healthy horses, (3) suggest a LUS scoring system, (4) identify horse variables that are associated to LUS changes after anesthesia. Methods: Twenty-five healthy adult horses undergoing elective surgery. Methods: Prospective hypothesis-driven observational study. LUS findings were recorded before anesthesia, 5 minutes in recovery, 15 minutes, 2H, 3H, 4H, 6H, and ...
Influence of screw head diameter on ex vivo fixation of equine lateral condylar fractures with 5.5 mm cortical screws.
Veterinary surgery : VS    March 18, 2022   Volume 51, Issue 4 576-591 doi: 10.1111/vsu.13797
Constant C, Zderic I, Arens D, Pugliese B, Gehweiler D, Gueorguiev-Rüegg B, Zeiter S.To determine the influence of screw head diameter on equine condylar fracture fixation with 5.5 mm cortical screws. Methods: Ex vivo, biomechanical study, blinded, matched-pair design. Methods: Fifteen pairs of equine third metacarpal (MC3) bones. Methods: Lateral condylar fractures were simulated by parasagittal osteotomies and repaired pairwise by 2 × 5.5 mm cortical screws of 8 mm (standard) or 10 mm (modified) head diameter. Interfragmentary compression at maximum screw insertion torque was measured. The instrumented specimens were pairwise stratified for biomechanical testing u...
Anesthesia Case of the Month.
Journal of the American Veterinary Medical Association    March 16, 2022   Volume 260, Issue 12 1-4 doi: 10.2460/javma.21.07.0327
Bartholomew KJ, Loeber SJ, Johnson RA.No abstract available
Strangulating left colon volvulus following nonsurgical castration in a 6-year-old donkey.
Veterinary research forum : an international quarterly journal    March 15, 2022   Volume 13, Issue 1 145-147 doi: 10.30466/vrf.2021.526717.3155
Azizi S, Masoudi H.Colic is a clinical syndrome and has been defined as a visceral abdominal pain and/or acute abdominal disease. It is a common cause of morbidity and mortality in horses. The most common forms of colics are related to gastrointestinal tract in nature and most often linked to colonic disturbances. However, colics are not well understood in donkeys compared to those of in horses and the literature is poor regarding bowel strangulating obstruction in donkeys. This report described the clinical signs and post-mortem necropsy findings of an abdominal colic due to the left colon volvulus following a ...
Surgery of the Equine Urinary Tract.
The Veterinary clinics of North America. Equine practice    March 10, 2022   Volume 38, Issue 1 141-153 doi: 10.1016/j.cveq.2021.11.010
Fubini SL, Delco M.Urinary surgery in the horse may be challenging. More straightforward procedures, such as urinary bladder or urachal defects, do not usually require specialized equipment or imaging, although laboratory work is helpful. Congenital or acquired conditions of the ureters or kidneys may necessitate advanced diagnostic work-ups including advanced imaging /or and minimally invasive procedures. Some surgery of the lower urinary tract is done in the sedated, standing adult horse. Surgery involving the kidney typically requires general anesthesia. Laparoscopy and associated tools are frequently used. A...
Full-thickness endotracheal tube defect resulting in an anaesthetic circuit leak.
Equine veterinary journal    March 10, 2022   Volume 55, Issue 1 66-68 doi: 10.1111/evj.13569
Miller L, Lord S.Loss of endotracheal tube (ETT) integrity secondary to dental damage is reported in the human literature. Objective: To describe this problem in equine anaesthesia. Methods: Case report. Conclusions: An 18-year-old Standardbred gelding presented out of hours with colic signs. Findings on clinical examination and pain refractory to analgesia meant that exploratory laparotomy was elected for. Prior to general anaesthesia (GA) leak testing of the anaesthetic machine was performed and the pilot balloon of the endotracheal tube (ETT) was inflated to confirm cuff integrity. Intermittent-positive pre...
Rib fractures in adult horses as a cause of poor performance; diagnosis, treatment and outcome in 73 horses.
Equine veterinary journal    March 1, 2022   Volume 55, Issue 1 59-65 doi: 10.1111/evj.13566
Hall S, Smith R, Ramzan PHL, Head M, Robinson N, Parker R.Rib fractures in adult horses are poorly documented. Objective: To describe the presenting signs, diagnosis, treatment and outcome of horses diagnosed with rib fracture. Methods: Retrospective case series. Methods: The clinical records and diagnostic images of all adult horses diagnosed with a rib fracture at three referral centres over a 15-year period were reviewed. Results: Seventy-three horses met the inclusion criteria. Horses presented due to either resistance to ridden work and poor performance (n = 41), lameness (n = 21) or trauma (n = 7). In four horses, the presenting complaint...
Incidence of carpal fractures and risk factors for recurrent fractures after arthroscopic removal of carpal chip fracture fragments in Thoroughbred racehorses.
The Veterinary record    February 28, 2022   Volume 190, Issue 10 e1482 doi: 10.1002/vetr.1482
Mita H, Tamura N, Fukuda K, Kuroda T, Kuwano A, Sato F.We aimed to investigate the recent incidence of carpal fractures and the risk factors for recurrent ipsilateral fractures after arthroscopic removal of clinically active unilateral carpal chip fracture fragments in Thoroughbred racehorses. The findings for horses managed under the Japan Racing Association that developed carpal bone fractures between 2014 and 2018 were retrospectively reviewed. The proportion of cases that developed a recurrent carpal fracture in the originally affected joint was calculated, and the risk factors for recurrent fractures were analysed. In total, 2858 carpal fract...
Three-dimensional printed surgical guides for keratoma removal in horses using computed tomography or magnetic resonance imaging-based segmentation.
Veterinary surgery : VS    February 28, 2022   Volume 51 Suppl 1 O43-O52 doi: 10.1111/vsu.13786
Biedrzycki AH, Morton AJ, Perez-Jimenez EE, Elane GL, Roe HA, Trolinger-Meadows KD.To report the technique, surgical approach, and postoperative features in horses treated via a 3-dimensional (3D) printed guide-assisted keratoma resection created using computed tomography (CT) or magnetic resonance imaging (MRI)-based segmentation. Methods: Five client-owned horses. Methods: Short case series. Methods: Horses were placed under general anesthesia for imaging (CT and MRI) and underwent a second anesthesia for surgery. Two horses had guides created from CT-based imaging, 3 horses had guides created from MRI. Various sized nonarbored hole saws were used to create accurate and pr...
An Analysis of Risk Factors for a Fracture or Luxation in Recovery From General Anesthesia in Horses: A Single Centre Study☆.
Journal of equine veterinary science    February 23, 2022   Volume 112 103914 doi: 10.1016/j.jevs.2022.103914
Bennell AJ, Wright RJH, Malalana F, Senior JM.Catastrophic fractures or luxations (FoL) sustained during recovery from general anesthesia are a significant cause of mortality during equine anesthesia. There is a lack of evidence regarding potential risk factors for a FoL occurring in the immediate anesthetic recovery period. A single center, retrospective, case-matched study was performed to identify risk factors for sustaining a catastrophic FoL during recovery from general anesthesia. Clinical data were obtained for horses which sustained a catastrophic FoL when recovering from general anesthesia from January 2011 to June 2020 in a sing...
Comparison of Flunixin Meglumine, Meloxicam and Ketoprofen on Mild Visceral Post-Operative Pain in Horses.
Animals : an open access journal from MDPI    February 21, 2022   Volume 12, Issue 4 doi: 10.3390/ani12040526
Lemonnier LC, Thorin C, Meurice A, Dubus A, Touzot-Jourde G, Couroucé A, Leroux AA.The analgesic efficacy of meloxicam and ketoprofen against equine visceral pain is unclear. The aim of this study was to compare the analgesic efficacy of meloxicam (M) and ketoprofen (K) to flunixin meglumine (F) following inguinal castration. Horses undergoing inguinal castration under general anesthesia were randomly assigned F (1.1 mg/kg), M (0.6 mg/kg) or K (2.2 mg/kg) intravenously two hours pre-operatively and 24 h later. A pain score (out of 31) was recorded blindly by a senior clinician and veterinary student before NSAIDs administration (T0), and after the first (T1) and second (T2) ...
Arthroscopic findings and long-term outcomes in 76 sport horses with meniscal injuries (2008-2018).
Veterinary surgery : VS    February 17, 2022   Volume 51, Issue 3 409-417 doi: 10.1111/vsu.13784
Davis JG, García-López JM.To report the findings and long-term outcome of 76 sport horses with meniscal injury. Methods: Retrospective case series. Methods: Seventy-six horses with 93 meniscal injuries in 85 stifles. Methods: Medical records of sport horses diagnosed with meniscal injury during arthroscopy were reviewed. Owner follow up was obtained via telephone interview ≥1.5 years postoperatively. Preoperative and intraoperative findings, and postoperative treatments, were analyzed for potential association with return to athletic performance. Results: The medial meniscus was involved in 82.8% of cases, with gra...
Computed tomographic assessment of fracture characteristics and subchondral bone injury in Thoroughbred racehorses with lateral condylar fractures and their relationship to outcome.
Veterinary surgery : VS    February 14, 2022   Volume 51, Issue 3 426-437 doi: 10.1111/vsu.13770
Cianci JM, Wulster KB, Richardson DW, Stefanovski D, Ortved KF.To investigate the effects of fracture characteristics and concurrent subchondral bone pathology identified with computed tomography (CT) on the racing performance of Thoroughbred racehorses with fractures of the MC3/MT3 lateral condyle. Methods: Retrospective cohort study. Methods: Thoroughbred racehorses (n = 50) with a fracture of the MC3/MT3 lateral condyle, which had preoperative CT and internal fixation performed. Methods: Medical records were reviewed for age, sex, limb, and surgical treatment. Computed tomography scans were evaluated to determine fracture characteristics including le...
Treatment of primary hyperparathyroidism in a Miniature Horse using chemical ablation of abnormal parathyroid tissue localized by 3-phase computed tomography.
Journal of veterinary internal medicine    February 12, 2022   Volume 36, Issue 2 798-804 doi: 10.1111/jvim.16390
Colmer SF, Wulster K, Johnson AL, Levine DG, Underwood C, Watkins TW, Van Eps AW.A 15-year-old Miniature Horse mare with persistently increased plasma calcium (total and ionized) and serum parathyroid hormone concentrations was presented for suspected primary hyperparathyroidism. Ultrasonography of the thyroid region identified an enlarged heterogeneous mass axial to the right thyroid lobe suggestive of an enlarged parathyroid gland, which was further confirmed using sestamibi nuclear scintigraphy and 3-phase computed tomography. Percutaneous ultrasound-guided ethanol ablation of the mass, a method not previously described in the horse, was performed under general anesthes...
Computed tomographic geometrical analysis of surgical treatments for equine recurrent laryngeal neuropathy.
American journal of veterinary research    February 8, 2022   Volume 83, Issue 5 443-449 doi: 10.2460/ajvr.21.03.0040
Tucker ML, Wilson DG, Reinink SK, Carmalt JL.To characterize the 3-D geometry of the equine larynx replicating laryngeal hemiplegia and 4 surgical interventions by use of CT under steady-state airflow conditions. Secondly, to use fluid mechanic principles of flow through a constriction to establish the relationship between measured airflow geometries with impedance for each surgical procedure. Methods: 10 cadaveric horse larynges. Methods: While CT scans were performed, inhalation during exercise conditions was replicated for each of the following 5 conditions: laryngeal hemiplegia, left laryngoplasty with ventriculocordectomy, left lary...
Ex vivo biomechanical evaluation of polyester and polyblend suture techniques to perform equine laryngoplasty.
Veterinary surgery : VS    February 7, 2022   Volume 51, Issue 3 497-508 doi: 10.1111/vsu.13777
Pressanto MC, Pascoletti G, Perkins JD, Zanetti EM, Beccati F, Santalucia V, Pepe M.To validate the use of a polyblend tape suture in equine laryngoplasty (PL). Methods: Experimental study. Methods: Thirty-two cadaveric larynges. Methods: Each larynx was randomly assigned to 1 of 4 groups: PL with polyblend tape suture (TigerTape), without (TT) or with a cannula (TTC) in the muscular process of the arytenoid cartilage, and PL with polyester suture (Ethibond), without (EB) or with a cannula (EBC). Construct stiffness, total migration, creep, and drift values were measured after 3000 cycles. The specimens were then loaded to failure to assess their residual properties: load a...
Infectious Uveitis in Horses and New Insights in Its Leptospiral Biofilm-Related Pathogenesis.
Microorganisms    February 7, 2022   Volume 10, Issue 2 doi: 10.3390/microorganisms10020387
Wollanke B, Gerhards H, Ackermann K.Uveitis is a sight-threatening eye disease in equids known worldwide that leads to considerable pain and suffering. By far the most common type of uveitis in Germany and neighboring countries is classical equine recurrent uveitis (ERU), which is caused by chronic intraocular leptospiral infection and is the main cause of infectious uveitis in horses. Other infectious causes are extremely rare and are usually clinically distinguishable from ERU. ERU can be treated very effectively by vitreous cavity lavage (vitrectomy). For proper indications of this demanding surgery, it is necessary to differ...
Comparison of the zip skin closure system with conventional suture for skin closure of ventral midline incisions in horses.
American journal of veterinary research    February 2, 2022   Volume 83, Issue 5 455-464 doi: 10.2460/ajvr.21.08.0135
Klein CE, Engiles JB, Roessner HA, Hopster K, Hurcombe SD.To compare the application and healing of the zip skin closure system (ZSCS) with sutured closure by use of a split-scar model of ventral midline incisions in horses in a prospective, randomized experimental study. Methods: 8 adult horses. Methods: All horses underwent an exploratory ventral midline celiotomy with a standardized 30-cm skin incision. Each horse was randomized to have either the cranial 15 cm closed with suture and caudal 15 cm with the ZSCS or vice versa (split-scar model). Skin closure time was recorded and compared. Photography and skin biopsies were taken preoperatively and ...
Agreement of High-Definition Oscillometry (HDO) and Invasive Blood Pressure Measurements at a Metatarsal Artery in Isoflurane-Anaesthetised Horses.
Animals : an open access journal from MDPI    February 2, 2022   Volume 12, Issue 3 363 doi: 10.3390/ani12030363
Twele L, Neudeck S, Delarocque J, Verhaar N, Reiners J, Noll M, Tünsmeyer J, Kästner SBR.High-definition oscillometry (HDO) over the metatarsal artery (MA) in anaesthetised horses has not yet been evaluated. This study aimed to assess agreement between HDO and invasive blood pressure (IBP) at the metatarsal artery, and to evaluate compliance with the American College of Veterinary Internal Medicine (ACVIM) consensus guidelines. In this experimental study, 11 horses underwent general anaesthesia for an unrelated, terminal surgical trial. Instrumentation included an IBP catheter in one and an HDO cuff placed over the contralateral MA, as well as thermodilution catheters. Systolic ar...
Effect of 15° Reverse Trendelenburg Position on Arterial Oxygen Tension during Isoflurane Anesthesia in Horses.
Animals : an open access journal from MDPI    February 1, 2022   Volume 12, Issue 3 353 doi: 10.3390/ani12030353
Tucker L, Almeida D, Wendt-Hornickle E, Baldo CF, Allweiler S, Guedes AGP.Lower than expected arterial oxygen tension (PaO) continues to be an unresolved problem in equine anesthesia. The aim of this randomized, crossover, and prospective study using six adult horses is to determine if a 15° reverse Trendelenburg position (RTP) increases PaO during inhalation anesthesia. Under constant-dose isoflurane anesthesia, dorsally recumbent horses were positioned either horizontally (HP) or in a 15° RTP for 2 h. Lungs were mechanically ventilated (15 mL/kg, 6 breaths/min). Arterial carbon dioxide tension (PaCO), PaO, inspired oxygen fraction (FiO), and end-tidal carbon dio...
The failure mode of a mechanically loaded equine medial femoral condyle analog with a void and the impact of lag and neutral screw placement.
Veterinary surgery : VS    January 31, 2022   Volume 51, Issue 3 474-481 doi: 10.1111/vsu.13765
Moreno CR, Santschi EM, Younkin JT, Larson RL, Litsky AS.To determine the failure method of simulated equine medial femoral condyle (MFC) subchondral bone defects under compression and the influence of screw placement on failure resistance. Methods: In vitro study. Methods: Composite disks (CD) simulating the moduli of yearling bone in the MFC. Methods: Four CD conditions were tested, all with a 12.7 mm void (n = 6 per condition): intact (no void), void only, void with a 4.5 mm screw placed in neutral fashion, and void with a 4.5 mm screw placed in lag fashion. Composite disks of each condition were tested under monotonic compression to 6000...
Abdominal Hernia in Equine: Animal Level Risk Factors and Repair Using Polypropylene Mesh.
Journal of equine veterinary science    January 29, 2022   Volume 111 103889 doi: 10.1016/j.jevs.2022.103889
Moustafa A, Elmetwally M, El-Khodery S, Hamed M, Gomaa N, Rizk MA.There is a paucity of information regarding the frequency and risk factors associated with the occurrence of an abdominal hernia in different equine species especially donkeys, and mules. In addition, the effectiveness of using polypropylene mesh for the surgical management of abdominal hernia in donkeys and mules is still unknown. The purpose of the present study was to evaluate the efficacy of using polypropylene mesh for the surgical treatment of abdominal hernia in horses, donkeys, and mules and to address the occurrence and risk factors associated with an abdominal hernia in the selected ...
1 18 19 20 21 22 206