INTUSSUSCEPTION 187 



Adhesions occur between the adjacent layers in a few hours 

 and finally the parts become necrotic and may perforate 

 leading to peritonitis. The rapidity with which these changes 

 occur depends upon the extent of the intussusception as the 

 farther the invagination the greater the pressure on the 

 bloodvessels; if the circulation be completely obstructed, 

 necrosis will occur in a few hours. 



Symptoms. — Intussusception manifests itself early by 

 abdominal pain, the tension on the mesentery producing 

 the first symptoms. It has been noticed in a few cases 

 that the animal will lie on its back in order to ease the 

 pain from mesenteric tension. Later symptoms of acute 

 enteritis become prominent, the feces frequently show the 

 presence of blood, there is tenesmus, colicky pains and 

 occasionally vomiting, and the vomitus may be mixed with 

 feces. Palpation of the abdomen will often reveal an elon- 

 gated enlargement of the bowel and slight pressure will 

 cause pain. Palpation is difficult in very fat animals or those 

 having a very thick-walled abdomen. 



Diagnosis.— The presence of the painful enlargement of 

 the bowel, bloody stools, tenesmus and the sudden occur- 

 rence are the principal diagnostic features. 



Prognosis.— Unfavorable in all cases not operated early. If 

 recognized early and reduced or the portion excised (enter- 

 ectomy) a good recovery may be expected. Spontaneous 

 healing may occur by sloughing of the invaginated portion 

 and adhesion at the anterior part. 



Treatment.— Intussusception of the posterior part of the 

 bowel may be reduced in the early stages by dilating the 

 bowel with rectal injections of large quantities of warm 

 water, using as much pressure as can be applied safely. Air 

 may also be used in the same manner. Purgatives or specific 

 stimulants to peristalsis should not be used as they only 

 serve to increase the invagination. Operative measures 

 should be at once resorted to when other efforts fail. A 

 laparotomy should be performed at the median line just 

 posterior to the umbilical scar, the enlarged portion of the 

 bowel sought and attempts made to reduce it by careful 

 manipulation. A small blunt probe or scalpel handle may 



