590 DETECTION OF TWIST OF THE COLON. 



recovery by retroversion. During 1890, 63 cases of rotation of the 

 colon were met with in the horses of the Prussian army, and during 

 1891, 52 cases. 



Jelkmann says the twist is usually towards the right, and is pro- 

 duced by distension of the upper portion of the colon and its dis- 

 placement from the left lower wall of the belly at the same time that 

 portions of the rectum are forced towards this spot. If the animals 

 rise after lying on the right side, the upper portion of the bowel, 

 which has been displaced towards the middle line of the belly, is 

 thrust downwards and finally twisted around its long axis. This 

 explains many cases ; but just the opposite sometimes occurs, and 

 twist takes place towards the left, as is shown by the reports of post- 

 mortem examinations in the Pathological Institute of the Berlin 

 College. Sometimes the upper layer of the colon is displaced towards 

 the centre line, sometimes towards the left abdominal wall. The 

 comparatively great length of the portion of bowel filled with food, 

 and its freedom to move, explain the frequent occurrence of rotation. 

 (For the normal position of the abdominal contents see Figs. 410, 

 411 and 412.) 



The symptoms are not characteristic, but a rectal examination 

 generally removes any doubt. When colic, at first slight, is accom- 

 panied by continued pain and becomes worse hour by hour, the 

 bowel sounds weaker, the pulse smaller and more frequent, and 

 some form of stoppage of the bowel seems certain, a rectal ex- 

 amination will generally clear up the point. In front of the anus, 

 one feels the distended colon, which may for the moment be mistaken 

 for the over-filled urinary bladder, but careful examination reveals 

 its real nature. The longitudinal muscular bands can be distinctly 

 felt, and show, not only that we have to deal with the colon, but 

 also in what direction torsion has occurred. When the bowel is 

 in its proper position, the bands run nearly parallel with the long 

 axis of the body ; but in twists, a change in their course is distinctly 

 appreciable. In torsion towards the right, they run backwards and 

 inwards ; in torsion towards the left, backwards and outwards. 

 According to Jelkmann, the rectal mesentery, whose fixed border 

 can be felt below the lumbar vertebrae, appears greatly stretched, 

 and in right rotation does not pass perpendicularly downwards, but 

 towards the left, and pressure on it causes the animal pain. Careful 

 examination of the direction of the bands of the colon seems of more 

 importance in diagnosis, and no doubt can exist either as to the 

 presence or direction of the torsion if they can be discovered, but the 

 posterior bands of the caecum, which can be distinctly felt when the 



