LAPAROTOMY. 573 



if possible, be drawn through the abdominal wound. The portion of 

 bowel coming from the stomach is immediately recognised by its 

 being distended, and should be kept closed by an assistant compressing 

 it. The bowel is now incised in its long axis immediately over 

 the foreign body, which is then removed. At this stage it is important 

 to keep the distended portion of bowel closed to prevent advancing 

 ingesta soiling the wound, and, in case of need, a clamp may be applied, 

 but not so tight as to bruise the bowel. It can be replaced by a 

 twisted strip of sterilised gauze applied with moderate tension around 

 both the afferent and efferent portions of bowel. Finally the intestinal 

 wound is closed with bowel sutures (Figs. 403 to 407). As it is very 

 important to bring the serosa of both sides into contact, and to make 

 the closure as perfect as possible without piercing the mucous coat, 

 which would perhaps lead to peritonitis, one of the methods recom- 

 mended by Gely, Lembert, or Wolfler should be employed. There- 

 after the surface of the intestine and of the wound is once more 

 cleansed, the abdominal muscles and skin are sutured with sterilised 

 material, and a proper dressing applied. Where the animal is par- 

 ticularly valuable continuous watching may be necessary to prevent 

 the dressing moving or being torn off. A dog operated on by Moller, 

 pulled off the dressing and loosened the sutures, occasioning prolapse 

 of the bowel and death. 



In the horse laparotomy has often been successfully performed 

 for the castration of cryptorchids, and McQueen, in a paper on 

 " Abdominal Surgery " read before the National Veterinary Associa- 

 tion in 1895, gives a series of cases in which accidental wounds pene- 

 trating the peritoneal cavity, with or without prolapse of abdominal 

 organs, have been successfully treated. He himself surgically opened 

 the peritoneal cavity in four experimental cases. In three he with- 

 drew and handled portions of intestine, incised the floating colon, 

 and closed the wound with sutures. In the fourth he divided and 

 afterwards united the jejeunum. The first case died of septic 

 pneumonia ; the two succeeding cases recovered, but for research 

 purposes were afterwards killed. The last case died in 39 hours. 



In practice, Dollar, Rickards, and Rogers unsuccessfully resected 

 a portion of floating colon. Smith and Garry have also performed 

 laparo-enterotomy for obstructed bowel, but the horses died. Felizet 

 in 1849 is said to have cured a miller's horse in France by removing 

 a calculus through a flank incision, but no such achievement has 

 been reported in England. Where operation has been attempted 

 it has usually been postponed until too late. 



Should the portion of bowel surrounding the foreign body be 



