186 DISEASES OF THE INTESTINES 



rapid pulse, serve to identify volvulus and differentiate it 

 from other more chronic forms of intestinal obstruction. 



Prognosis.— Unfavorable unless recognized early when a 

 prompt operation affords relief. 



Treatment.— Injections of large quantities of warm water 

 or of air into the rectum may be beneficial in some cases. 

 However, owing to the rapid changes taking place in the bowel, 

 laparotomy should be performed early, and an attempt 

 made to reduce the volvulus. Should the involved part of 

 the intestine be necrotic, enterectomy must be employed to 

 remove the entire part affected. 



INTUSSUSCEPTION. 



Definition.— The invagination of a part of the intestine 

 into an adjacent portion. 



Etiology. —The exact causes are not known, although from 

 the conditions under which it occurs and by experiments 

 it is believed to be due to irregular innervation by which 

 a given spot is contracted while immediately below it there 

 is a dilatation, thus permitting the latter to invaginate the 

 former. It may be produced by supercatharsis, increased 

 production of bile (icterus), or the taking of cold water 

 immediately following severe exercise, all of which excite 

 innervation or produce sudden increase in peristalsis. Pre- 

 disposing causes are constipation; dilatations following 

 removal of fecal masses by enterotomy; end-to-end enterec- 

 tomy, the circular cicatrix being incapable of contraction or 

 dilatation which favors invagination; tumors in the intestinal 

 wall. Intussusception may involve any part of the small 

 intestine. The small intestine may pass in the ileocecal 

 valve. Invagination of the colon or rectum may also occur. 



Pathology.— Intussusception is a condition in which one 

 part of the bowel slips into another forming a sausage-like 

 enlargement of varied length. The enlargement is slightly 

 curved from tension of the mesentery. As a result of the 

 constriction, blood circulation is interfered with and often 

 entirely arrested. In the early stages there is slight redden- 

 ing, later the parts are swollen, congested and of bluish color. 



