434 ^'olvulus and Torsion of the Intestine. 



Torsion of the cecum can probably be often diagnosticated 

 by rectal exploration as was shown in a case which the authors 

 observed. 



Torsion or volvulus of the small colon (often called the ab- 

 dominal portion of the rectum) can always be ascertained by 

 rectal examination. If a portion of the small colon, situated 

 very near the rectum, has been closed, the introduction of the 

 hand through the narrowed place is impossible, perhaps a linger 

 may be pressed through. One finds the intestinal wall folded 

 and tender in front of the impediment ; bloated loops of intes- 

 tines can be felt through the wall of the rectum. If torsion has 

 occurred more towards the front, the findings are similar to 

 those in strangulation of the small colon (see page 419), with 

 this difference, that in volvulus with the small intestine the 

 strangulated small colon is surrounded by bloated loops of 

 small intestine. 



Formation of knots and partial mesenteric torsion of the 

 small intestine may in some cases be ascertained directly by 

 the observation that loops of intestine, which are bloated to 

 the utmost and very tense, suddenly pass over into a folded 

 cord, which, on pressure or on pulling, proves to be tender. 



In horses that are not too large, total torsion of the small 

 intestine around the root of the mesentery may be recognized 

 by finding a folded, thick cord, in a vertical plane, supposed to 

 pass through the middle of the left kidney, immediatel}' below 

 the vertel)ral column, which leads towards the right or left and 

 is connected with a number of very tense loops of small intes- 

 tine. In some cases one may also find loops of small intestine 

 wound around the caudal portion of the left division of the 

 colon, or around the upper portion of the cecum. In a consider- 

 able proportion of cases one cannot find the seat of a torsion or 

 a volvulus of the small intestine, but can only ascertain very 

 great distension and eventually tenderness of some loops, while 

 the rest of the small and the large intestine are normal (circum- 

 scribed meteorism). Only rarely does rectal examination furnish 

 a completely negative result, namely, when the displacement has 

 occurred in the anterior parts of the abdominal cavity and when 

 only a short loop is involved. 



Rectal examination, or palpation of the abdomen, may re- 

 veal conditions similar to those of internal strangulation (see 

 pages 419 and 420) in cattle, hog and carnivora. Probst saw 

 the case of a dog with torsion of the rectum and with l)loody 

 feces (probably the torsion was originally not complete in this 

 case). The authors saw a similar case in a horse with torsion 

 of the rectum. 



Course. The clinical picture sometimes develops during 

 the course of other colicky affections, but, as a rule, it has a 

 very sudden onset. As in displacements of the intestines in 



