PROLAPSUS OF THE RECTUM. 



73: 



Pig. 20. 



Stitching rectum (tobacco- 

 bag stitch) ; a, method or 

 stitching ; 6, stitch tied. 



After replacing the intestine it is generally necessary to place 

 a stitch around the perineum, so as to prevent the recurrence of 

 the protrusion. What is called a tobacco- 

 pouch stitch is carried around the anus, and 

 when the strina;s are drawn it will be seen, 

 as in the cut (Fig. 20), that it prevents the 

 protrusion by drawing the anus together. 

 The sewing of the rectum by this stitch 

 closes up the opening sufficiently to pre- 

 vent the bowel coming out, but not enough 

 to prevent the escape of liquid fecal matter. 

 It is not advisable to apply cold irrigations 

 or inject astringents, as the dog is very apt to 

 strain more violently after application of 

 either of these remedies. At the same time, 

 if the trouble is caused by diarrhoea, give 

 opium; and if caused by constipation, ad- 

 minister saline purgatives. Stockfleth ad- 

 vises that a series of pins should be placed 

 aroiind the rectum and united with threads, 

 and thus produce a greater constriction from the cicatrix when, 

 the irritation heals, so as to hold the parts in position. 



Grey made an opening on the median line of the abdomen and 

 drew back the intestine and stitched it to the opening with catgut 

 sutures. 



When the prolapsus has been of long duration and reduction, 

 seems impossible, it is best to fake means to remove the protruded 

 portion of the intestine. 



The best method is to place the animal under ether, and having laid it 

 on a table with the posterior extremities elevated, the prolapsed portion is 

 pulled as far as possible out of the rectum. It must then be rubbed in the 

 hands to remove as much blood from it as possible, or a rubber band 

 wound around it from its extremity to its base, and finally ligated at its base, 

 and then by means of a bistoury the protrusion is cut off about one-half 

 of an inch from the ligature. 



After the bloodvessels are taken up, by means of a continuous stitch 

 sew up the serous membrane ; then afterward sew the muscular and 

 mucous membranes, taking care not to penetrate the mucous membrane 

 entirely through ; the continuous stitch is much better, as it makes the union 

 of the lips of the wound much closer ; the rubber band is removed, and th& 

 stump is pushed back into the opening. 



