THE STOMACH AND INTESTINES 189 



septic, and an attempt made to mo\e it into a spot where the 

 \N'all is still healthy. The site of incision having been decided 

 upon, the material \\-ithin the gut is gentl}- but firmly 

 squeezed above and below for about half an inch or an inch, 

 and the bo\\el clamped to prevent its return, and so prevent 

 exit of infective matter when the incision is made. 



I'or this purpose clamps (see Fig. 130) can be used, although 

 pieces of rubber tubing held tightly around the bowel with 

 arter}- forceps improvise \ery well, or (Maunsell's suggestion) 

 safetj'-pins padded with sponge or ^\•adding. 



The bowel is then careful!}- packed around \\ith boiled 

 aseptic lint or wadding, an incision made in the longi- 

 tudinal direction in the least congested part, as far awaj- 



Fig. 130. — Bowel Clamp (Makins). 



from the mesenteric attachment as possible, and the 

 obstructing substance extracted. 



The edges of the wound and the intestine above and below 

 as far as the clamped portion are thorough!)- cleansed and 

 disinfected, Lembert's or Czerny-Lembert's sutures (see 

 p. 55) are inserted, and the wound in the abdominal wall 

 treated as after an ordinary laparotomy (see p. 158). 



Prognosis and After-treatment. — Careful dieting, as already 

 described after gastrotomy (see p. 179). If the patient has 

 not already become exhausted, the prognosis, although 

 ahvaj's gra\-e, may be considered hopeful. 



Interesting cases of recovery after operation have been reported by 

 Vennerholm' and Pauer.^ In Vennerholm's case the foreign body was 



1 Veterinary Record, vol. x., p. 327 (Mayall's translation). 



2 Ibid., vol. xii., p. no. 



