530 UMBILICAL HERNIA. 



asepsis and prevent prolapse of the intestine. Perfect cleanliness 

 ensures the first, and carefully-inserted quilled sutures lead to proper 

 union of the edges of the wound. 



Should resection of a necrotic portion of intestine be deemed 

 advisable, it is very important to avoid infecting the peritoneal 

 cavity with intestinal contents, and carefully to provide for union 

 of the ends of the resected bowel. The intestine is drawn forward 

 as far as necessary, and protected by layers of cloth dipped in warm 

 disinfectant solution. 



After excising the necrotic portion with scissors, the ends of the 

 intestine must be rinsed with carbolic or normal saline solution, and 

 their contents, as far as possible, removed without soiling the wound. 

 An assistant using both hands gently compresses the gut between 

 his fingers, and the ends are then so brought together that the two 

 serous surfaces are in apposition. To effect this, the free edges of 

 the posterior portion are turned inwards, the anterior end pushed 

 into this, and the two sewn together with closely applied stitches. 

 After once more carefully cleansing the intestine, it is returned, 

 the wound disinfected, and stitches inserted as above described. 

 Experiments made many years ago with the simplest apparatus in 

 cases of invagination show that under some circumstances, especially 

 in oxen, resection of the intestine may prove successful (compare 

 with the section on " Suturing the Intestine "). 



VI.— UMBILICAL HERNIA (OMPHALOCELE, EXOMPHALOS). 



By union of the visceral plates in the linea alba, the abdomen 

 closes during uterine life as far as the annulus umbilicalis, which 

 remains open for the umbilical cord, and after birth ceases to exist 

 on account of obliteration of its vessels. In new-born animals the 

 umbilical ring not infrequently appears abnormally large, so that 

 the umbilical cord does not completely fill it, in consequence of which 

 the skin and peritoneum either immediately or in the first few weeks 

 after birth, yield to the pressure of the abdominal contents, and 

 allow the latter to pass through under the skin. This condition, 

 which occurs in different classes of animals, though most frequently 

 in horses, oxen, and dogs, has been termed umbilical hernia, and 

 is divided into two forms, — viz., congenital, which is apparent at 

 birth, and acquired, which appears during the first few weeks there- 

 after or subsequently. 



As a rule, a portion of the colon, caecum, small intestine, or some- 

 times omentum, is found in the hernial sac, which is composed of 



