44 VETERINARY SURGICAL OPERATIONS 



skin around it. It is advisable always to first insert' the 

 trocar into the canula to prevent the distribution of ingesta 

 along its tract through the abdominal muscles. 



Sixth Step. — Protecting the Wound. — When the relief 

 is complete and permanent no special protection of the cuta- 

 neous wound is necessary because the elasticity of the skin 

 leaves but a very small, almost imperceptible, breach, but 

 when the relief is only partial and the stretched condition of 

 the skin keeps the orifice open, it is well to apply a coating 

 of vaseline over the surface to protect against contamination 

 with the litter during the subsequent colicky pranks of the 

 still uneasy patient. 



ITERATION.— In the course of any given attack of 

 colic the operation may have to be repeated two, three, four 

 or even five or more times before the gas formation ceases. 

 The duty of the surgeon here is that of simply resorting to it 

 as often as it is found necessary to rid the intestinal canal of 

 the accumulating gases. In no case should there be any 

 hesitancy of repeating the operation on account of previous 

 performances, if the degree of the recurrent distention war- 

 rants. 



In iterant operations a different point of entrance is se- 

 lected for each. It is advisable to operate as far as possible 

 from preceding points, — one inch or more, — in order to pre- 

 vent abscess formation, which would be favored by riddling 

 a small area with a number of punctures. 



ACCIDENTS AND SEQUEL^.— (i) Hemorrhage 

 may occur from two sources; from blood vessels in the ab- 

 dominal walls or from blood vessels in the intestines. 

 Branches of the lumbar arteries, the circumflex ilii, their col- 

 lateral veins, or the colic arteries or veins may be breached 

 as the instrument is plunged into the bowels. This accident 

 is unavoidable and usually not serious. When large vessels 

 of the intestines are breached, blood in considerable quanti- 

 ties may be forced or splashed out of the canula when the 

 trocar is withdrawn from the canula ; it having first flowed 

 into the intestinal lumen and then having been forced out by 

 the outward gush of the gas. It sometim.es happens that con- 

 siderable blood flows imperceptibly into the colon and is only 

 noticed on the second or third day when evacuated with the 

 feces, or that it flows into the peritoneal cavity outside of the 

 intestines, where it is often found post-mortem, or is sus- 

 pected^ because of the local peritonitis that often follows the 

 operation. These intestinal haemorrhages, although some- 

 times very profuse, are generally harmless. They are una- 



