380 OPEEATIONS ON THE DIGESTIVE APPARATUS. 



ENTEROTOMY. 



The division or puncture of the intestines, or enterotoniy, 

 is an operation the object of vs^hich is to facilitate the exit of gases 

 contaiaed ia these organs, to prevent their excessive dilatation, 

 and to obviate certain too commonly fatal complications. It vs'as 

 mentioned at an early day by Vegetius, especially in connection 

 vrith the treatment of vnnd coUcs, but not again spoken of until 

 1776, when Eoem, Bomvinghausen, and at a later date, Barrier 

 and Herouard obtained good results from it. Bourgelat and 

 Chabert recommended it ia the early stages of the disease, but, 

 notwithstanding the favorable dicta of aU these authorities, the 

 operation was not fully admitted to a place in the domain of 

 veterinary surgery until Bernard, Dieterichs, Palke, Rey, Schaack, 

 HajTie, Eckel, Blendeiss, Charlier and others, had proved by nu- 

 merous facts that when performed under favorable circumstances 

 it is not only harmless, but is capable of iasuruig results of the 

 most beneficial character. 



Intestiaal puncture is radicated in cases of tympanitis or flat- 

 ulent coUc, due to indigestion, or to an intestinal obstruction, 

 and must be performed whenever the accumulation of gases has 

 resisted ordinary forms of treatment. The iadication, in our opin- 

 ion, is to operate early ia the disease, as an almost positive means 

 of avoiding the compHcations, or rupture of the stomach or lacera- 

 tion of the intestines, which, if unchecked, may accompany the flatu- 

 lent accumulation. Enterotomy is also recommended in cases of 

 strangulated hernia, when the gases which are imprisoned ia the 

 hernial intestines prevent its reduction. Imbert used it with ad- 

 vantage in reduciag a strangulated ventral hernia. In former 

 days Chabert performed the operation through the rectum, and 

 Abadie, ia 1875, reported a case in which he reached the iates- 

 tines through the vagina. But while it may be possible to ob- 

 tain access to the dilated iatestiaes through these charmels, it 

 is evident that it is a method which must oppose more difficul- 

 ties and iavolve more complications than the puncture through 

 the flank. 



The point of selection for the operation is about the center of 

 the space formed forward by the border of the last rib, behind by 

 the external angle of the ilium, and above by the extremity of the 



