TORSION OF THE DOUBLE COLON 277 



in the extreme. Now, in semitorsion at the suprasternal 

 and diaphragmatic flexures, with the distended pelvic 

 flexure itself constituting the tumour, we find the said 

 tumour occupying the position where normally the pelvic 

 flexure should be — namely, just on the pelvic brim, and 

 to the left sooner than to the right side. It is not forced 

 right into the pelvis. And this latter, which I have itali- 

 cized, is just what we might expect. For this reason : 

 With semitorsion at the suprasternal and diaphragmatic 

 flexures, there is necessarily some degree of shortening of 

 the colic loop, which shortening is sufficient to prevent 

 even the violent paining of the animal forcing its end — 

 namely, the flexure — into the pelvic cavity. 



The second way in which distinction may be made is 

 to pass the hand in front of the tumour and feel for the 

 longitudinal muscular bands of the colon. When they 

 can be felt, then the question as to whether we are dealing 

 with the pelvic flexure or simply with a portion of the 

 small intestine can no longer be in doubt. Tautened by 

 the torsion, one or more of them may be distinguished 

 and even grasped by the exploring hand. Needless to 

 say, this is the more certain method ; and when the bands 

 can be felt in this tightened and twisted condition, then 

 torsion of the colon can be diagnosed without risk of error. 

 Indeed, there are observers (notably Moller^ and Cadeac^) 

 who describe in some detail the way in which, by manipu- 

 lation of these bands, torsion from left to right may be 

 distinguished from that in the direction of right to left. 



I must confess that I have not yet succeeded in doing 

 this myself. In some degree I believe I have been handi- 

 capped by the unwieldy size of the organs of the large 

 Shire animals in which the whole of my cases in this dis- 



• Moller, ' Operative Veterinary Surgery,' p. 287. 

 2 Cadeac, 'Pathologie Interne,' p. 333. 



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