PROLAPSE OF THE RECTUM 219 



causes persist, in some cases the eversion of the mucosa may 

 be followed by a prolapsus of the rectum. 



The prognosis in prolapsus of the rectum is usually favor- 

 able, unless the bowel becomes necrotic, or complications 

 higher up in the bowel take place from infection, etc. There- 

 fore, the prognosis depends very largely upon the length of 

 time the bowel has been protruded. When treated early and 

 before pathological changes have developed in the exposed 

 bowel, the prognosis should be considered favorable. 



Treatment.— In the mild cases of everted mucosa, when 

 taken early, applications of cold water or astringent solutions, 

 such as alum (2-5 per cent.), are usually efficient in reducing 

 the size of prolapsed portion so that it can be returned to its 

 proper position. Further application of astringents will 

 assist in keeping it in position. Only small quantities of the 

 solutions should be employed, owing to the danger of induc- 

 ing undue straining. Should this method fail in keeping the 

 mucosa in its proper position, it can be grasped with small 

 dressing forceps, pulled out gently and cauterized with the 

 thermocautery, making two or three longitudinal lines, being 

 careful to prevent going through the mucosa. Should the 

 prolapsed mucosa show necrosis, it is best to remove it in the 

 following manner : The prolapsed portion should be grasped 

 firmly with dressing forceps and drawn out until the normal 

 membrane appears; it is held in this position and a double 

 suture applied through the base and tied either way around 

 the enlargement. The ligature should be applied rather 

 firmly to prevent hemorrhage and retraction of the tissues 

 which would loosen it. The ligated portion is then removed 

 with the scissors. The base is returned to the rectum and 

 treated with antiseptic and astringent solutions. 



Prolapsus of the rectum is often quite difficult to reduce. 

 When taken early, before much swelling has taken place, it 

 can usually be pushed back into place, by digital kneading, 

 or by the use of a bougie or a well rounded sound. Placing 

 the animal in a pendant position with the head downward, 

 will assist in the replacement. When the parts are in posi- 

 tion, it is advisable to resort to some method of retaining 

 them in place for a time, otherwise they are quite liable to be 



