DEPARTMENT OF SURGERY. 
919 
wound. Extra-peritoneal wounds are not common, but may 
result from extra-peritoneal nephrotomy, or in the removal of 
ureteral calculi. In most cases they reunite without suturing ; 
but should suturing be indicated, a few catgut stitches should 
be applied. Transverse incisions are more serious than the 
longitudinal, and in many cases must be approximated or in- 
vaginated by the Van Hook method ( Journal of American 
Medical Association , March 4, 1893), which will be mentioned 
in the anastomosis of ureters. 
II. Accidental Wounds-- The ureters are occasionally injured 
by gunshot, or punctured by sharp or probed by pointed objects, 
such as forks, knives or pointed sticks. These accidents, how¬ 
ever, are more common in hunting dogs than in other domestic 
animals. Gunshot wounds are usually caused by a hunter’s 
accidental or ill-directed shots; by brutal attendants; by 
forcible blows, falls or kicks, causing injuries in the lumbar 
region. Small animals may receive injuries of this uature by 
being run over by light vehicles. I11 human subjects, injuries 
to the ureters are often attributed to overstretching, but in do¬ 
mestic animals, no cases of this nature have ever been attributed 
to this cause. If overstretching is a cause for rupture of ureters 
in quadrupeds, the accident might follow high or long jumps 
made by these animals. 
III. Neoformations. —New growths in or around the ureter 
which would obstruct the passage of urine from the kidney to 
the bladder are indications for ureteral surgery ; but when of a 
malignant type and the renal portion is involved, it is useless to 
attempt to effect a cure by anastomosis ; when such conditions 
are found, it is advisable to remove the kidney instead of con¬ 
fining our efforts to the ureter. When new growths in the sur¬ 
rounding structure compress the ureters or involve the ducts to 
such an extent as to interfere with their function, anastomosis or 
implantation of ureters may be indicated {Journal of American 
Medical Association, Feb. 16, 1901), but as already mentioned, 
the operator should be guided by the part of the ureters involved, 
in selecting the course to be taken. 
IV. Calculi. —A calculus located in the ureter is sometimes 
an indication for ureterotomy or ureteral anastomosis. The 
calculi may be lodged in any part of the duct, but are most fre¬ 
quently located in the pelvis of the kidney ; occasionally in the 
anterior and vesical portion of the ureter, but seldom in the 
middle portion. If a calculus can be located in the renal por¬ 
tion of ureter without surgical means it should be removed by 
