Torsion of the Uterus 711 



Before applying traction or carrying out other manipulations, 

 after the organ has been replaced, we would advise the practitioner 

 to search carefully in every part for transverse rupture of the 

 cervix uteri or other important injuries, because, if such rupture 

 has occurred during the torsion of the organ, it should be discov- 

 ered promptly and the owner of the animal advised of the condi- 

 tions, that he may relieve the veterinarian from any responsibil- 

 ity which might rest upon him otherwise because of the later 

 discovery of the condition. 



De Bruin aptly remarks that, in these cases, examination should 

 be made before any operation is begun, with a view to deter- 

 mining whether the case has already been handled by empirics or 

 others, and in this way the outcome rendered more doubtful. 



Torsion of the uterus is frequently irreducible. In one 

 case which we attended, the torsion had apparently existed for 

 about two weeks, and the spiral folds of the cervix and vagina 

 had become so firmly adherent to each other, Figs, i [7 and 118, 

 that the organ could not very well have been untwisted. 



Reduction was also made virtually impossible by the fact that 

 the fetus was dead, emphysematous, and swollen to thrice its 

 normal volume, and so great a volume of fluid had transuded 

 into the uterine cavity as to increase the weight and volume of 

 the organ to such a degree that there was neither room within the 

 abdominal cavity to turn the organ nor power enough in the arms 

 of a man to bring about its rotation. In addition, the uterus was 

 so firmly adherent over its entire surface to the surrounding or- 

 gans and abdominal walls that a replacement of it was impossi- 

 ble, until it had first been dissected loose. 



In another of our cases, the organ was free from adhesions, 

 the torsion had existed for some days, the emphysematous 

 fetus and the transuded liquid had so thoroughly distended the 

 uterus, and its walls were so voluminous, that it occupied vir- 

 tually the whole abdominal cavity, and there was simply a want 

 of room in which to turn the organ, and its weight was entirely 

 too great for a man to lift. 



In those cases where the torsion has ended in a complete trans- 

 verse rupture through the cervix or vagina, reduction is evi- 

 dently impossible. When gangrene of the uterus has occurred, 

 reduction, if possible, is useless. 



When torsion is irreducible, there is virtually no hope for 



