ABDOMINAL WOUNDS, WITH PROLAPSE OF INTERNAL OROANS. 513 



organ, constitutes a dangerous complication. The prolapse per se 

 is not so dangerous, but there is much difficulty in returning and 

 retaining it in position, preventing soiling and injury and the entrance 

 of infective materials into the peritoneal cavity. Walthard showed 

 by experiments on dogs and cats that the injurious action of the 

 air on the peritoneum depended on the abstraction of moisture, and 

 not on direct chemical irritation, as had previously been supposed. 

 Early reposition is therefore the most important indication. 



Omental prolapse is least dangerous, because, in the event of 

 its return being difficult or impossible, a large piece may be removed 

 without bad consequences. This is often done with impunity in 

 castrating horses and other animals. Where the omental protrusion 

 is large and contains important blood-vessels, a portion is withdrawn, 

 a sterilised ligature applied to the healthy part, the portion below 

 cut off, and the remainder thrust back into the peritoneal cavity, 

 or, still better, into the abdominal wound, to which it becomes 

 attached, preventing egress of other organs and, possibly, entrance 

 of infective wound discharge. If the protruded omentum has become 

 soiled or necrosed, its removal is imperative. All experienced prac- 

 titioners recommend its being further withdrawn and cut off. Moller 

 has repeatedly seen abdominal wounds in dogs and cats, in which 

 the prolapsed omentum was converted by injury into a black greasy 

 mass with an offensive smell, but when this was excised, healing 

 quickly ensued. 



Prolapse of the bowel is more dangerous, because the viscus 

 must be returned to the peritoneal cavity. Recoveries nevertheless 

 occur in all animals, provided the protruded portion be carefully 

 cleansed and replaced, and recurrence prevented. It is important 

 to effect reposition before the serous covering has become dry, infected 

 or inflamed. When the serosa is injured its vitality is lowered and 

 the conditions are all in favour of the growth of infective organisms, 

 which are a very serious menace to life. Prolapses of the large in- 

 testine are generally least troublesome. In the horse, prolapse of 

 the colon or caecum, following injury to the under portion of the 

 abdominal walls, is more easily reduced and kept in position than 

 that of the small intestine, because the colic mesentery is shorter 

 than that of the small intestine, the viscus is less sensitive to operative 

 interference, and there is less risk from infective organisms introduced 

 into the abdominal cavity. Drolshagen treated a foal, which had 

 been wounded by a horn thrust ; the omentum and bowel were pro- 

 lapsed, the extruded bowel, which was as large round as a bee-hive, 

 hindered the animal's movements, and compelled it to lie down 



