184 Surgical Diseases and Surgery of the Dog 



the bowel on the distal side being usually collapsed. The obstructed 

 portion being found, it is drawn out of the cavity, retained well out- 

 side and away from the opening in the wall until the completion of 

 the operation. At the same time it should be protected and kept 

 warm with sterilized gauze wrung out in warm water. The condi- 

 tion of the tissues in the immediate neighborhood is to be carefully 

 noted and according as to whether the bowel is viable or not will 

 depend the necessity of simple incision or excision of a part. At 

 this stage some writers recommend application of bowel clamps a 

 few inches above and below the lesion in order to restrain the out- 

 flow of fecal matter through the opening. A simple clamp can be 

 improvised out of a piece of rubber tubing held in position by artery 

 forceps. But there is some danger of causing unnecessary injury 

 to delicate tissues and it is certainly useless on the distal side of the 

 obstruction where the bowel is invariably empty. Baragz lost a case 

 by compressing the bowel too tightly with a metal clamp. On the 

 proximal side a considerable quantity of feculent matter may be 

 found. I believe it is better to speedily evacuate the gut of this 

 putrefactive matter from as great a distance as possible beyond the 

 seat of an artificial opening, than it is to leave such dangerous filth 

 in close proximity to a wound we desire shall rapidly heal. An 

 incision is then made longitudinally at the greater curvature, and 

 immediately over the obstruction. No advantage is gained by try- 

 ing to force the latter back to another part of the bowel for delivery, 

 for if the tissues at the seat of obstruction are in such state of 

 mortification that they will not stand interference, enterectomy is the 

 only alternative. Where the obstruction is fecal and of such bulk 

 and extent as to occupy the greater part of the colon or rectum, 

 necessitating opening of a large tract, it is better to make a series 

 of interrupted incisions along the greater curvature. The obstruct- 

 ing body being removed, the operator gently compresses the bowel 

 between thumb and first finger for a good distance above and 

 towards the seat of lesion, so that all fecal matter may be expelled 

 from the neighborhood, care being taken that none of it enters the 

 peritoneal cavity. The parts are then thoroughly washed with 

 warm sterile water, sutured (see Enterorraphy) , again washed, and 

 returned to the cavity, the omentum replaced as nearly as possible 

 in its normal position, and the wall closed (see Celiotomy). 



It has been suggested that the insertion of the sutures may be 



