I 



RUMENOTOMY 4ll 



ing upon the adhesion of the contacting peritoneal surfaces 

 to prevent diffuse peritonitis and upon the slow process of 

 cicatrization to finally close the resulting fistula after sev- 

 eral months, has rightly been discontinued. 



Fifth Step. — Suturing the Abdominal Incision.— The 

 muscles and skin are closed with removable buried sutures or 

 single interrupted ones. A small orifice, which is packed 

 with gauze, is left open interiorly for drainage. 



Sixth Step. — Dressing.— The edges are dusted with iodo- 

 form and then coated thickly with collodion. 



AFTER-CARE.— Feeding with only limited quantities 

 of liquid food is essential, for if rumination is immediately 

 stimulated by the ingestion of solids the contractions of the 

 rumen will prevent all chances of primary union of the in- 

 cision. 



At the end of eight days the sutures in the skin are re- 

 moved and the wound submitted to treatment indicated by 

 its condition. 



SEQUEL.ffi. — i. Perforation of the Rumen is the most 

 common and the most formidable untoward complication, 

 and while not necessarily fatal, many animals die therefrom, 

 and the patient is always in a more or less critical state of 

 health until cicatrization has finally closed up the breach. 

 When the sutures fail to accomplish their purpose and per- 

 foration results there is no other choice than that of allowing 

 the healing process to take its own course. 



2. Haemorrhage.— More or less profuse bleeding some- 

 times occurs into the peritoneal cavity after the wounds have 

 been closed, but as the accident is seldom noticed except on 

 post-mortem when the patient has died from other causes 

 than the haemorrhage itself, no treatment is ever admin- 

 istered. 



3. Peritonitis. — Local peritonitis always ensues, and 

 usually results in adhesions of the rumen to the parietes about 

 the region of operation. Diffuse peritonitis, which always 

 results fatally, follows unclean surgery, especially in de- 

 bilitated subjects. 



4. Shock is common when the disease for which the 

 operation was performed was of too long standing. Bloats 

 of several hours' duration and necrosis of the rumen from 

 foreign bodies are among the conditions which, when re- 

 lieved, end in post-operative collapse and death after a few 

 hours. The state is prevented in acute bloat by slow evacu- 

 ation of the rumen, and in the more chronic conditions by 

 timely intervention. 



