PROCEDURES AGAINST CHOKE IN RUMINANTS 42 1 



SEQUELS AND ACCIDENTS.— i. Rupture of the 

 oesophagus at the seat of impaction is a common accident, 

 when poor judgment is displayed in the use of the pump. It 

 is manifested by an almost immediate appearance of a state 

 of collapse that ends fatally in a few hours. 



2. Recurrence of the choke is also common, but this can 

 in no way be attributed to the effect of the operation. On 

 the contrary, the operation would tend to prevent recur- 

 rence by coming to the rescue of the weakened walls. Re- 

 currence indicates a serious incurable dilatation. 



Procedures Against Choke in Ruminants. 



INDICATIONS. — In ruminants choke presents an en- 

 tirely different proposition from choke in solipeds. Here 

 the obstruction is generally a solid object lodged on ac- 

 count of hurried ingestion. The obstruction is as frequently 

 cervical in the ruminant as it is thoracic in solipeds, on ac- 

 count of the anatomical disposition of the oesophagus in the 

 two species. In solipeds the lumen diminishes toward the 

 stomach, while in the ruminant it is trumpet-shaped in- 

 feriorly. 



The treatment of choke in ruminants consists of a number 

 of radical efforts to dislodge the obstruction and ends by 

 sending the subject to the slaughter house if all of them fail. 



The routine is as follows: — i. Attempt to move the 

 object into the pharynx, whence it is removed manually. 



2. Attempt to push it into the stomach with the probang. 



3. Attempt to slice it into small pieces with a fine tene- 

 tome passed into it from without. 4. CEsophagotomy. 



TECHNIQUE OF CESOPHAGOTOMY.— The oper- 

 ation can only be successfully performed in the cervical 

 region. The field over and around the protrusion is cleansed 

 and the oesophagus exposed by a longitudinal incision, over- 

 lapping the obstruction superiorly. The oesophagus is in- 

 cised just above the obstruction, and not immediately over 

 it. At first only a very small incision is made over the an- 

 terior part of the object, through which the nature can be 

 determined. If found to be a vegetable or other substance 

 that can be cut into pieces, it is reduced into fragments and 

 removed piece by piece with forceps. On the other hand, 

 if it consists of a more solid body the incision is enlarged 

 anteriorly and the object squeezed or drawn out through it. 



The incision is closed with a number of removable buried 

 sutures of catgut (see page 106) and the skin with inter- 



