PERFORATING ULCER OF THE STOMACH. 



Causes : round ulcer, foreign bodies, parasites. Symptoms : those of 

 ulcer, followed by infective peritonitis, fistula, pleuritis, pericarditis. 

 Treatment : of fistula. 



This may be the result of the gradual deepening of the round 

 ulcer, yet in the domestic animals it mostly comes from the 

 presence of sharp pointed bodies. These may be enumerated as 

 needles, pins, nails, wires, sharp bones (dog), whalebone (horse), 

 forks, knives (cattle), and even gravel. The burrowing of the 

 spiroptera has seemed to cause perforation in the horse. All 

 causes of ulceration may, however, lead to perforation. 



The symptoms are those of gastric ulcer, already given, fol- 

 lowed by the more specific ones of perforation. These in their 

 turn differ according to the parts involved. In the horse and 

 dog the perforating ulcer usually opens into the peritoneum, in- 

 ducing a fatal infective peritonitis. In cattle the foreign body 

 sometimes passes toward the heart, enveloped in a protecting mass 

 of new formed tissue and proves fatal by heart disease. In other 

 cases it has been found to proceed downward toward the sternum 

 and to escape by a fistula formed beside the ensiform cartilage. 

 In other cases it has taken a direction toward the right wall of 

 the abdomen where it formed a fistula, discharging alimentary 

 matters. In still other cases it has opened into the peritoneal 

 cavity with fatal effects. 



Treatment in the case of external fistula, without implication 

 of the peritoneum, consists in the removal of the foreign body, 

 and the stimulation of granulations along the tract of the fistula 

 by the application of an ointment of tartar emetic to the interior. 

 Should this fail the fistulous tract may be scraped to make it raw, 

 and the edges may then be drawn together with sutures taking a 

 deep hold of the skin. 



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