286 VETERINARY STATE BOARD 



because of the constriction of the urethra, and must be removed be- 

 fore reposition can be effected. 



Give causes, symptoms and treatment of inversion of the uterus. 



Causes : Failure of the os uteri to close after parturition, tardy- 

 involution of the uterus, and retained placenta are potent, causative 

 factors. Sloping floors, close confinement, and overfeeding are 

 contributory, if not direct, causes. 



Symptoms: The prolapse may be partial or complete; that is, 

 there may be simply a beginning invagination, or the inversion may 

 be complete with the whole uterus turned inside out and hanging 

 from the vulva. The walls of the prolapsed organ are continuous 

 with the vagina and vulva, and there is more or less displacement of 

 these organs. Occasionally the bladder is carried forward with the 

 floor of the vagina. Intestines may be forced through the pelvic 

 cavity into the inverted uterus. The condition may he further 

 complicated by lacerations, inflammatory degenerations, etc., of the 

 protruding parts. 



Treatment : Carefully cleanse and disinfect the prolapsed organ 

 with 0.5 per cent, solution of phenol in normal salt solution. Place 

 the patient in lateral recumbency with the posterior parts elevated. 

 Remove any adherent portions of placenta and replace the organ by 

 careful manual pressure. If the uterus is badly congested it may 

 be very difficult to do this. The congestion may be overcome by 

 elevating the uterus above the body level and applying a pressure 

 bandage, beginning at the free extremity. After returning the 

 organ, push the eornua back as far as possible with the clinched fist 

 and inject tepid, sterile water to complete the unfolding of the 

 intussusception. If necessary, administer narcotics to prevent ex- 

 pulsive efforts. Should the uterus be badly wounded or necrotic, 

 amputation may be necessary. (See answer to following question.) 



What is metrotomy? When is it indicated and how should it be per- 

 formed? 



Metrotomy refers to the incising of the uterus. Metrectomy is 

 the excision, or amputation, of the uterus. (Many persons incor- 

 rectly use these two terms synonymously. Believing that the inter- 

 rogator refers to amputation of the uterus, the following answer is 

 given.) 



Amputation of the uterus is indicated in case of prolapse when 

 reposition of the organ is impossible ; when the organ is badly in- 

 flamed, necrotic, or wounded. 



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