380 OPERATIONS OX THE DIGESTIVE APPARATUS. 



ENTEEOTOMT. 



The division or punctm-e of the intestines, or enterotomy, 

 is an operation the object of which is to facilitate the exit of gases 

 contained in these organs, to prevent their excessive dilatation, 

 and to obviate certain too commonly fatal comphcations. It was 

 mentioned at an early day by Vegetius, especially in connection 

 with the treatment of wind cohcs, but not again spoken of imtil 

 1776, when Koem, Bomvinghausen, and at a later date, Barrier 

 and Herouard obtained good results from it. Bourgelat and 

 Chabert recommended it in the early stages of the disease, but, 

 notwithstanding the favorable dicta of all these authorities, the 

 operation was not fully admitted to a place in the domain of 

 veterinary surgery until Bernard, Dieterichs, Falke, Key, Schaack, 

 HajTie, Eckel, Blendeiss, Charlier and others, had proved by nu- 

 merous facts that when performed under favorable circumstances 

 it is not orJy harmless, but is capable of insuring results of the 

 most beneficial character. 



Intestinal puncture is indicated in cases of tympanitis or flat- 

 ulent cohc, due to indigestion, or to an intestinal obstruction, 

 and must be performed whenever the accumulation of gases has 

 resisted ordinary forms of treatment. The indication, in our opin- 

 ion, is to operate early in the disease, as an almost positive means 

 of avoiding the complications, or rupture of the stomach or lacera- 

 tion of the intestines, which, if unchecked, may accompany the flatu- 

 lent accumulation. Enterotomy is also recommended in cases of 

 strangulated hernia, when the gases which are imprisoned in the 

 hernial intestines j^revent its reduction. Imbert used it with ad- 

 vantage in reducing a strangulated ventral hernia. In former 

 days Chabert performed the operation through the rectum, and 

 Abadie, in 1875, reported a case in which he reached the intes- 

 tines through the vagina. But while it may be possible to ob- 

 tain access to the dilated intestines through these channels, it 

 is e^^dent that it is a method which must oppose more difficul- 

 ties and involve more comphcations than the puncture through 

 the flank. 



The point of selection for the operation is about the center of 

 the space formed forward by the border of the last rib, behind by 

 the external angle of the ihum, and above by the extremity of the 



