192 CANINE MEDICINE AND SURGERY 



Esophagotomy 



When a foreign body becomes so firmly lodged 

 in the esophagus that it cannot be moved by the 

 forceps or probang, the esophagus must be opened 

 and the foreign body extracted. If in the cervical 

 region the procedure is as follows : Place patient 

 in the dorsal position, -with neck well extended. Then 

 apply a local anesthetic of four-per-cent solution of 

 cocain and adrenalin. Have at hand a razor, scal- 

 pel, artery forceps, tissue forceps, needles, catgut 

 sutures, and silk sutures. 



Technic. — The operative area is shaved and dis- 

 infected in the usual manner and the cocain solu- 

 tion injected subcutaneously. 



An incision above the foreign body is made 

 through the skin with the scalpel, and the esophagus 

 is exposed by blunt dissection, the vessels and nerves 

 being pushed aside. The esophagus is then incised 

 and the foreign body extracted. Then the esophageal 

 wound is closed with catgut sutures, first the mucous 

 membrane and then the muscular and fibrous layers 

 of the wall. 



The skin incision is sutured with silk, drainage 

 being provided for at the lower margin of the 

 wound. ^ 



Water must be withheld for at least twenty-four 

 hours and all food for four days, the patient being 

 fed per rectum, after which well minced and sloppy 

 food may be given in small quantities. Unless this 

 part of the treatment is fully carried out, healing 

 is interfered with, infection invariably takes place, 

 and an esophageal fistula often results. 



Tracheotomy 



Tracheotomy, or incision into the trachea for the 

 purpose of inserting a tube, is essentially an emer- 



