382 Internal Closure of the Intestine. 



If the obturating body does not stretch the part closed up, 

 because the comparatively large mass is simply held back by 

 the narrowing portion of the bowel without interfering with it, 

 as is, for instance, the case with large calculi situated in the 

 stomach-like dilatation of the colon, then the obturation of the 

 intestinal lumen leads to the same consequences as they are 

 found in fecal impaction (see page 366). If, however, the for- 

 eign body has been pushed into a narrower portion of the in- 

 testine, it will stretch and irritate the intestinal wall and cause 

 attacks of powerful convulsive contractions, that is, colicky 

 pains. In such and also in the previously mentioned cases, as 

 already explained when discussing the pathogenesis of fecal im- 

 paction, convulsive painful contractions of intestinal portions 

 situated nearer to the stomach will occur likewise. If the body 

 wedged in the intestinal lumen is pointed or sharp-edged, it may 

 produce continuous pain. 



As in all forms of obturation of the intestinal lumen, the 

 peristalsis becomes abolished behind the obturated point, and 

 often increased for some time in front of the obstruction ; later, 

 however, the peristalsis also ceases in the portion between the 

 obstruction and the stomach as stretching of the bowel occurs 

 from the accumulating contents. Bloating occurs only after 

 some time in these portions, if their contents are more or less 

 fluid; the meteorism does not, however, reach a very high de- 

 gree, because normal intestinal contents do not form much gas 

 and the latter is easily absorbed. In closure of the posterior 

 portions of the large bowel feces collect in front of the obturated 

 point if the appetite has in the mean time remained fairly good ; 

 the feces desiccate and extend the lumen of the bowels. Sec- 

 ondary gastric dilatation does not infrequently occur under such 

 circumstances in horses. 



Pressure or direct injury exerted by the obturating body 

 not infrequently brings on necrosis or inflammation, and these 

 may extend to the internal layers of the wall, even to the peri- 

 toneal covering. Necrosis or convulsive contractions of the in- 

 testinal wall may not rarely cause intestinal rupture. As long 

 as complications (inflammation, rupture, possibly high degrees 

 of bloating, dilatation of the stomach) are absent, there are no 

 general symptoms, such as are generally seen after absorption 

 of bacteria and their toxins, after peritonitis and in consequence 

 of severe bloating. 



Symptoms. In horses the visible signs and sj^mptoms of 

 internal obturation are identical wdth those of impaction in a 

 part of the cases, particularly if the first portion of the small 

 colon has been closed up (see page 367), except as to defecation 

 and as to the onset of the affection. In obturation the clinical 

 picture develops suddenly in distinction from impaction of feces, 

 and after one or two defecations, complete constipation comes 

 on. In other cases there are severe attacks of colic without any 



