THE STOMACH AND INTESTINES 171 



discharged from hospital on the 20th. With the exception of a buried 

 suture abscess some months afterwards, the patient had no return of the 

 coHcky pain. 



Puncture of the stomach or bowel must be done with all 

 attention to antiseptic precautions, as already described (see 

 pp. 2 and 158), the site of operation being shaved and dis- 

 infected, whilst the trocar and cannula is boiled. This instru- 

 ment (see Fig. 120) should be of small size, an ordinary 

 exploring needle (see Fig. 36) answering very well, and is 

 inserted under local anaesthesia (eth3-l chloride or anestile 

 answer splendidly) through the skin over the most distended 

 spot, and directly into the stomach or bowel. For the 

 stomach, the instrument is inserted on the right side, about 

 an inch behind the last rib, and pointed forwards ver}' 

 cautiously so as to avoid the liver or diaphragm. The safest 

 plan is, as soon as the skin has been penetrated, to withdraw 

 the point of the trocar within the cannula, and explore with 

 the blunt end of this for the distended organ. This will yield 

 on pressure, whereas the liver and diaphragm each offer a 

 solid resistance. Puncture of the stomach is followed by a 

 rush of gas when the stilette is withdrawn. The usual place 

 chosen for bowel puncture is either high up in the flank, 

 about midway between the last rib, the sacrum, and the 

 lumbar vertebrae, or about an inch on one side or other of 

 the median line. When the gas present has escaped the 

 instrument is removed, the operator carefully pushing the 

 skin away from him towards the abdomen as the stilette is 

 pulled out. 



Foreign Bodies in the Stomach. 



Meat-skewers, hatpins, sticks, pins, needles, nails, tacks, 

 beads, stones, corks, coins, rubber or wooden balls, etc., are 

 swallowed by both dogs and cats, especially the former, and 

 at times give rise to a good deal of trouble, which neces- 

 sitates surgical interference. 



Gastrotomy, too, is occasionally necessary for the removal 



