302 DISEASES OF THE UTERUS 



reposition. In case this does not succeed, it is advisable to 

 perform laparotomy under anesthesia, and pull the uterus 

 back into position. Care should always be taken to avoid 

 tearing the tissues, and it is best to have an assistant manipu- 

 late the parts in the vulva, and at the same time exert some 

 pressure so that the entire prolapsed portion will at the 

 same time go back into position. It is advisable to suspend 

 the uterus to the abdominal wall after it has been withdrawn 

 in order to prevent further prolapsus. This can be done 

 easily by simply including the serous and muscular coats of 

 the uterus in the sutures when closing the abdominal walls. 



In case the prolapsed portion is necrotic or gangrenous 

 it should be amputated at once. The parts are cleansed 

 thoroughly with antiseptics, and the prolapsed portion 

 drawn out from the vulva until healthy tissue appears. A 

 ligature is applied around the entire mass as high up as pos- 

 sible. It should be placed in position by drawing it tight 

 to avoid postamputation hemorrhage. The mass is then 

 removed with a scissors or knife. Hemorrhage should be 

 controlled, if present. The stump is thoroughly washed with 

 antiseptics and returned to the vagina. The vagina should 

 be irrigated with antiseptics for a few days following the 

 operation. The ligated portion will slough away in a few 

 days. 



TORSION OF THE CORNUA UTERI. 



This is a condition occurring occasionally in bitches pre- 

 vious to or at the time of parturition. A twist occurs at the 

 junction of the cornua with the body of the uterus, prevent- 

 ing the birth of the fetuses. 



Symptoms. No special symptom of torsion of the cornua 

 will be observed. It may be necessary to make a careful 

 examination to reveal the exact condition; in some cases 

 an explorative laparotomy must be made. 



Treatment. The torsion can be reduced by performing 

 laparotomy. In case it is found that the circulation has been 

 so disturbed as to cause necrosis, it will be best to amputate 

 the entire organ. 



