178 CANINE AND FELINE SURGERY 



cloths, the foreign body being sought for and brought close 

 up against a portion of the wall where the bloodvessels are 

 small or absent, and an incision made directly over it. 

 Usually, as soon as the stomach is punctured, a certain 

 amount of gas rushes out, and, as it may carry fluid contents 

 with it, this should be guarded against by making a pre- 

 liminary puncture with a fine trocar and cannula. Should any 

 fluid escape, it must immediatel}- be caught before it can 

 reach the peritoneum. 



The foreign body is extracted, the internal edges of the 

 wound carefully cleansed with antiseptic solution, and a 

 close row of silk Czerny-Lembert or Lembert (see p. 55) 

 sutures inserted with a small, round, milliner's needle. The 

 first row passes through all three coats, the second row 

 being of Lembert's pattern and inserted through the serous 

 and muscular coats onlj-, about a sixth or a fourth of an inch 

 from the edges of the wound, so that they act as a double 

 protection against the exit of fluid. Particular care must 

 be taken to close the small ' pucker ' which is left at either 

 end of the wound. 



With a gastric ulcer the chief trouble lies in the difficulty 

 of making an accurate diagnosis ; the operative procedure 

 consists in making an elliptical incision so as to remove all 

 the necrosed edge, and drawing the sound portions of the 

 wall together as already described. The abdominal cavity 

 must be carefully examined for any material which may 

 have escaped, this being thoroughly removed with antiseptic 

 swabs. 



Foreign bodies in the lower part of the oesophagus 

 usually consist of large pieces of bone, gristle, etc., \\'hich 

 ha\c been greedil)' swallowed, and which cannot enter the 

 cardiac orifice of the stomach, and cannot be pushed down 

 \N'ith the probang or brought up by an emetic (see p. 142). 

 In one case we were successful in removing a very large 

 piece of gristle by means of a strong slender pair of dressing 



