PROLAPSE OF THE RECTUM. 105 



antiseptic precautions must be adopted, and laparotomy per- 

 formed under anaesthesia; the tumour is then sought for, and 

 removed by h'gature and the knife, or whatever way is deemed 

 advisable by the operator, in order to get as little hjemorrhage 

 as possible, the abdominal wound being sutured and treated in 

 the usual way. 



Excision of the Omentum.— A portion of omentum is fre- 

 quently included amongst the contents of the hernial sac, and 

 its return is often a matter of difficulty. If considered neces- 

 sary, its excision may be practised without the slightest fear, 

 provided due attention be first paid to any blood vessels in 

 its meshes, these being carefully ligatured. We have repeatedly 

 had occasion to remove large portions of omentum, and, in at 

 least one case, we have taken away practically the whole of the 

 organ with the best of results. 



Prolapse of the Rectum. Reduction.— Reduction of a pro- 

 lapsed rectum should be effected by careful manipulation with 

 the fingers, covered by a thin cloth soaked in cold antiseptic 

 solution, care being taken to avoid injury from the nails ; a 

 blunt instrument (such as a metal thermometer case) manipu- 

 lated up the lumen of the rectum is often of material help. 

 When returned, sutures may be put across the anus, or, as 

 recommended by Miiller,! a tobacco pouch suture may be in- 

 serted. This consists of thin tape or fairly stout silk passed 

 through the skin in and out completely around the exterior 

 of the anus, the two ends being drawn together tolerably tight, 

 like the strings of a purse or bag, and tied. Stockfleth^ advises 

 a similar procedure for constricting the rectum, by placing pins 

 at intervals around the anus and uniting them with threads. 

 Pessaries introduced into the rectum usually do more harm 

 than good, and act as a continual source of irritation. Gray^ 

 and Li^naux * have successfully treated cases by laparotomy, 

 the prolapsed bowel being withdrawn with the fingers and 



1 " Diseases of the Dog " (Glass's translation), p. 73. ^ Idem. 



3 "Veterinary Journal, "Vol. XL., p- 401. 



4 "Veterinary Record," Vol. XI., p. 561. 



