514 ABDOMINAL WOUNDS, WITH INJURIES TO CONTAINED ORGANS. 



frequently. After thorough cleansing the bowel was returned, a 

 portion of the omentum cut off, the wound sutured and a dressing 

 applied. Though it had a few slight attacks of colic, the patient 

 appeared restored to health in three weeks, but four months after- 

 wards it died. Post-mortem showed that the small intestine had 

 passed through a rupture in the mesentery, and become strangulated. 

 Kleinpaul saw a penetrating abdominal wound in the umbilical 

 region of a mare, caused twelve hours previously by injury from 

 the teeth of a harrow. A portion of the small intestine, as large as 

 a man's fist, was prolapsed, oedematous, and swollen. This was 

 replaced, an iodoform dressing applied, and food being withheld 

 for four days, perfect healing resulted. Fourteen days later the 

 mare gave birth to a foal and did well. 



In treatment of prolapsed bowel, uterus, or other abdominal 

 viscus, the chief point is to prevent injury and soiling. For this 

 purpose, if large animals have to be cast, a broad cloth soaked in 

 disinfectant fluid is first passed round the body. The wound and 

 its neighbourhood, together with the protruding portion, are then 

 carefully cleansed with a lukewarm disinfecting fluid (carbolic, salicylic, 

 or sublimate solution), and endeavour made to reduce the prolapse, 

 which effected, the wound is once more cleansed, any foreign bodies 

 carefully removed, and the parts stitched up. In some cases it may 

 be necessary to enlarge the wound before reduction can be effected. 

 The after-treatment is similar to that described in penetrating wounds. 

 Should the protruded bowel have become necrotic recovery is rare, 

 and the formation of an artificial anus or resection, which is worth 

 attempting, offers the only chance of saving life (compare " Foreign 

 Bodies in the Bowel "). Small doses of opium check the action 

 of the bowel and diminish danger of peritonitis. 



(d) Abdominal Wounds with Injuries to Contained Organs. In 

 herbivora the colon is most frequently injured, on account of its 

 great area, its distension with hard food, and its fixed position. The 

 more mobile small intestine being generally filled with fluid frequently 

 evades the object producing the injury. In this way, as experiments 

 have shown, pointed instruments, and even projectiles, may penetrate 

 the abdomen deeply without injuring this intestine. Horses fre- 

 quently recover from injuries of the colon and caecum, although their 

 peritoneum is much more sensitive than that of the ox, dog, or pig. 



Guilhelm (Stockfleth) saw a horse with a wound produced by a horn 

 thrust 5£ inches in front of the umbilicus, and the under portion of the 

 double colon protruded in a mass as large as a man's head. A wound in 

 the bowel, 3£ inches in length, discharged food material. This was stitched, 



