426 Volvulus and Torsion of the Intestine. 



taneously with it stagnation of the blood occurs in the affected 

 portion. 



On the basis of this definition postmortem toreion, which is com- 

 paratively frequent, must be separated from volvulus and torsion ; and 

 also displacements of the intestine which are not really pathologic in 

 character and occur quite commonly when certain portions of the intes- 

 tine are distended with masses of gas or feces, which are, however, not 

 accompanied by an encroachment upon the intestinal lumen, nor by a 

 stagnation of blood in the intestinal wall. 



Occurrence. Volvulus and torsion of the intestine occur 

 vriih rare exception only in horses. About 2-5.5% of the colics 

 of the stomach and intestines are due to this cause. Oppenheim, 

 Reicliert, v. Ow, Guittard and Joehnk have each seen one case 

 in cattle; Ries two cases; Hess saw torsion of the cecum in a 

 calf four days old. Glage saw a few cases of torsion of the 

 cecum in hogs. Lienaux and Probst each saw a case of volvulus 

 in a dog; Johne a case in an elephant. 



Volvulus and torsion in horses are not seen everywhere equally often. This 

 depends upon a difference of susceptibility in various breeds and on differences in 

 the attendance and in the use of horses in different countries. Torsion of the cecum 

 is most frequent in countries and states where the heaviest horses are kept (the 

 affection is more frequent in South Germany than in North Germany). An increase 

 of the number of eases of torsion of the cecum has been noticed more recently and 

 is probably due to the fact that more attention has recently been directed towards 

 torsion of the cecum, which is not always easy to detect even anatomically. 



The disease is seen comparatively frequently in army horses. Between 1892- 

 1908 the horses of the Prussian army furnished 71,532 cases of colic, among which 

 were 2,893 cas-es (49f) of volvulus and torsion; 1,585 cases (1.93'/0 of volvulus 

 with rare examples of torsion of the small intestines, or of volvulus or torsion of the 

 small colon; 1,.532 cases (2.14'7r) of torsion of the colon; ninety-two cases (0.12%) 

 of torsion of the cecum. In 8,426 cases of death from colic this form of intestinal 

 displacement was represented in 34.59^ ; among these volvulus and torsion of the 

 small intestines in 16.1%, torsion of the colon in 18.2%. 



In the Berlin Clinic there were 8,686 cases of colic (1897-1907), and 437 of 

 these (5%) were due to volvulus or torsion; volvulus or torsion of the small intes- 

 tines or of the small colon occurred 183 times (2.1%) ; torsion of the large colon 

 242 times (2.8%) (in four cases of the colonic tlexure) ; and there was one case 

 of torsion of the cecum. In 1,408 fatal cases, displacement of the small intestine 

 and small colon was represented with 13%, and displacement of the colon with 17.1%. 



During the years 1889-1894 and 1896-1908, 3,336 cases of colic were seen at 

 the Dresden Clinic; among these were 183 cases (5.5%) of volvidus and torsion; 

 sixty-five cases (1.95%) were volvulus of the small intestines; 117 cases (3.5%) 

 torsion of the colon and one case (0.03%) torsion of the cecum; 36.6%- of the 

 deaths from colic were due to this form of intestinal displacement and among these 

 23A% to torsion of the colon and 13% to volvulus of the small intestine. 



From 1900-1909, 5,487 cases of colic were seen in the Budapest clinic; among 

 them 101 cases (1.8%) of volvulus and torsion, viz., fifty-four cases (0.98%) of 

 volvulus or torsion of the small intestine; forty-four cases (0.03%) of torsion of 

 the cecum, and one case (0.01%) of torsion of the small colon; of the fatal cases 

 13.9% were due to volvulus or torsion of the intestines. 



Etiology. Volvulus and torsion of the intestines are with- 

 out doubt brought about in a majority of cases by mechanical 

 causes. Experimental proof of this statement has been fur- 

 nished by observations that animals acquired this intestinal dis- 

 placement immediately after certain mechanical injuries, and 

 died from it (Mayer, Glage, Lienaux), or that intestinal torsion 



