110 DISEASES OF THE STOMACH AND BOWELS 



time good. The pulse and conjunctiva usually are about > 

 normal. Obviously when enteritis, septic intoxication or 

 rupture occur the general condition becomes bad. 



Impaction Complicated with Abnormal Displacement. — 

 Forms. — The following abnormal displacements of the bowel 

 have been noted: Torsion of the large bowel (colon and 

 cecum), volvulus of the small bowel, intussusception of the 

 ^mall bowel, incarceration of the bowel (inguinal canal, 

 epiploic foramen, rents in, the diaphragm, omentum, mesen- 

 tery, etc.), and strangulation of the intestines from tumors. 



All of these pathological displacements lead to a sudden 

 occlusion of the bowel and fatal colic. They constitute 

 about 5 per cent, of all colic cases. Of great practical impor- 

 tance are: 



(a) Displacement of large bowel. 



(b) Displacement of small bowel. 

 Displacement of Large Bowel. — Most commonly this 



consists in a rotation (torsion) of the left colons around 

 their long axes. On account of their free position in the 

 abdominal cavity, contrary to the colons on the right side; 

 a certain predisposition to abnormal displacement is present. 



Etiology. — The exciting causes are usually primary im- 

 pactions behind the point of torsion. Therefore an impac- 

 tion of the upper may lead to torsion of the lower colons, 

 or an impaction of the lower to torsion of the upper colons. 

 Impaction may be determined in at least 80 per cent, of all 

 cases of displacement of the large bowel. Impaction induces 

 in the bowel which is in front of it a violent antiperistaltic 

 movement whereby secondarily a torsion follows. In other 

 instances paralysis of the bowels due to embolism is the 

 cause. Very rarely rolling in horses suffering from colic 

 may lead to displacement. 



Diagnosis. — A correct diagnosis can be arrived at only 

 through rectal examination. Very important in this regard 

 is the course of the bands of the left lower colon. In place 

 of their normal straight course the bands will be found 

 bent spirally to the right or to the left. The twist is always 

 opposite to the direction of the bands. For instance^ the 

 common twist of the left layers of the colon is to the right; 



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