The Abdomen 159 



progressive emaciation, are prominent symptoms. Pyloric neoplasms 

 may be palpated in the later stages when the animal is reduced to 

 mere skin and bones through inanition. The stomach is usually 

 much dilated. The symptoms are very similar to constriction-ob- 

 struction of the intestine, and explorative celiotomy may be neces- 

 sary to enable the practitioner to arrive at a correct diagnosis. 



Treatment. Non-malignant strictures are amenable to treat- 

 ment, but malignant neoplasms are best left alone. The simplest 

 way to remedy occlusion by stricture and render the tract again 

 permeable is by the operation of gastro-enterostomy. 



Surgery of the Stomach 



It has been repeatedly demonstrated that it is possible to suc- 

 cessfully perform severe operations on the stomach, even to the 

 extent of removing the entire organ. In 1810 Merrem attempted 

 resection of the pylorus on three dogs which, however, died. In 

 1876 the operation was again attempted by Gussenbauer and Von 

 Winiwarter. Their experiments proved that the operation was not 

 necessarily dangerous, but they lost most of their animals from 

 peritonitis. Levy resected the pylorus, using the Murphy button, 

 and experienced a mortality of fifty per cent. It was then found 

 that the operation of resection of the pylorus was more complicated 

 and took much longer than that of Gastroenterostomy, and that 

 subsequent perforation was more common owing to insufficiency 

 of the sutures. 



Kaiser, Czerny, Carvallo and Pachon, Monari and Filipi, Fisher 

 and Frouin tried total ablation of the organ, but they all left 

 a portion of the cardia, as it was very difficult to effect reunion 

 of the esophag^is and duodenum. A small sac usually developed 

 from the remnant and fulfilled gastric functions. In one of 

 Czerny's cases the animal survived the operation five years. In 

 one of Monari's the animal lost weight steadily. A great difficulty 

 lay in the fact that traction on the esophagus led to rupture of the 

 adhesions between esophagus and diaphragm, which gave rise to 

 pneumothorax. 



On the other hand, physiologists and clinical operations have 

 shown that simple incision or Gastrotomy with Gastrorrhaphy is 

 by n« means a very serious undertaking. 



