430 ECTASIiE, DIVERTICULA, AND RUPTURES OF THE (ESOPHAGUS. 



may cause inflammation and destruction of the mucous membrane, 

 especially during the earlier stages and before it becomes gradually 

 thickened and more resistant. 



Prognosis in these cases is usually unfavourable. If ectasia does 

 not endanger life, it seriously interferes with nutrition and the use 

 of the animal, and is usually incurable. By regulating the diet it 

 may be possible to keep the animals at work ; fat cattle should be 

 prepared for slaughter. 



Treatment. In ectasise, particularly when extensive, therapeutic 

 treatment scarcely promises any good result, but in diverticula in 

 the cervical portion of the oesophagus something may be done, both 

 in horses and cattle, by operation, as is shown by the cases related 

 by Reinemann, Schwerdtfeger, Moisant, Reichel, and others. The 

 dilated portion of the mucosa may be replaced or excised, and the 

 rupture in the muscle brought together by sutures. With antiseptic 

 precautions, the operation is not attended with much danger. This 

 is the most promising treatment in animals, but in chronic cases 

 is more easily described than carried out, especially if the rupture 

 in the muscular coat is already cicatrised and fixed to the neighbouring 

 parts by much cicatricial tissue. The operation can, however, be 

 tried. 



Procedure is similar to that of incising the oesophagus. After 

 returning the mucosa, the muscular coat is, where practicable, care- 

 fully sutured with catgut or silk stitches inserted close together ; 

 bad results naturally follow if the stitches tear out. Where this 

 course is impossible, the diverticulum must be opened, a piece of 

 the dilated mucous membrane excised, and the parts brought together 

 in the above fashion. Moisant applied a sort of clamp during eating 

 and drinking, and obtained good results in a horse, and afterwards 

 in two cows. Careful stitching of the muscular and mucous coats 

 is, however, not only simpler, but equally successful. Reinemann 

 effected a cure, although the stitches tore out in two days, owing to 

 inappropriate feeding. Granulations gradually close the opening. 

 Reichel operated on oxen in the standing position. To prevent 

 the stitches tearing out, nothing more than water should be given 

 during the ensuing twenty-four hours, and during the next few days 

 only fluid nourishment. In complete rupture of the cervical portion 

 of the oesophagus, the same treatment is recommended as in injuries 

 from sharp substances. Nothing can be done in ruptures of the 

 thoracic and abdominal portions. 



