220 DISEASES OF THE RECTUM AND ANUS 



thrown out again by the animal straining. A tobacco-pouch 

 suture, which is used to constrict the anal opening, is often 

 used successfully, making the constriction just sufficient to 

 hold the parts in position, and to allow soft or liquid feces to 

 be passed. However, as soon as this suture is removed the 

 prolapsus often recurs. 



Should these methods fail to replace the prolapsed rectum, 

 or hold it in position, laparotomy should be performed (see 

 Laparotomy), and the prolapsed bowel returned to its proper 

 position by gentle traction. Thef bowel when returned to 

 the cavity should be held in place by suturing same to the 

 abdominal wall (ventrofixation) . The sutures should be 

 applied carefully so that they only pass through the serous 

 and muscular coats of the bowel. Several of these sutures 

 should be applied to firmly fix the bowel in position. Laxa- 

 tives or laxative foods are indicated to prevent constipation 

 and pressure on the posterior bowels. Should the prolapsed 

 portion be much swollen, necrotic, or severely inflamed, this 

 method is not advisable, as it would act as a foreign body and 

 induce severe straining, resulting in a repetition of the former 

 condition. Should the prolapsed portion show evidences of 

 marked pathological changes, it is advisable to resort to 

 amputation, which is done in the following manner: The 

 animal is given a general anesthetic, placed on the table in a 

 ventral position, and the parts involved thoroughly cleansed 

 with an antiseptic solution. The prolapsed bowel is then 

 grasped with a bowel clamp, gentle traction used until 

 normal tissues appear, and a previously sterilized small, 

 rubber tube applied close to the anus, to act as a tourniquet. 

 A circular incision should be made through the external 

 intestinal wall, a short distance posterior to the tourniquet, 

 and parallel to the anal margin. Seize the severed external 

 tube at the anal margin with small hemostatic forceps, to 

 prevent its retraction and draw it out gently to bring its 

 serous coat in contact with the serous coat of the internal 

 tube. These two surfaces should be sutured using sterilized 

 cat-gut, silk or linen, making interrupted sutures the entire 

 circumference of the incised portion, ("are should be taken 

 in inserting these stitches, as they should only pass through 



