368 
DEPARTMENT OF SURGERY. 
part of it may be removed in returning it, thus forming an 
opening through which the intestines may pass and form a her¬ 
nia ( hernia interna abdominis ) which at times becomes strangu¬ 
lated. Frequent colics or intestinal occlusion following the 
return of an omental prolapse is very suggestive that something 
of that kind exists, but the true condition can only be ascer¬ 
tained by performing celiotomy and exploring the cavity; this, 
however, is not easily done in. herbivorous animals, but in car¬ 
nivora this procedure should not be overlooked when the indi¬ 
cations demand such interference. An omental prolapse is gen¬ 
erally not so serious as an intestinal or that of any other organ 
of the abdominal cavity. The mutilated part and all that is 
likelv to beeome necrotic can easily be removed, but before re¬ 
turning it into the cavity it should be thoroughly cleansed and 
all haemorrhage arrested. 
Treatment. —The first object in treating wounds of this char¬ 
acter is to prevent the prolapse from being injured and infected. 
If the patient is a large animal and requires casting, a provis¬ 
ional dressing should be adjusted in such a way as to protect 
the prolapse during the procedure. The prolapse, wound and 
skin surrounding the wound, should be thoroughly cleansed, 
the prolapse returned into the cavity, the opening properly su¬ 
tured, the required dressings carefully applied, and the bandages 
substantially adjusted. Should no indication of sepsis appear 
the dressing may be allowed to remain until the sixth or sev¬ 
enth day, or at least until the third or fourth, when the danger 
of infection is past. If the part of the intestines that formed 
the prolapse should become necrotic, a resection of the diseased 
portion is the only procedure that will increase the probabilities 
of recovery. 
Abdominal Wounds Complicated with Visceral Injury.-— 
These wounds are caused in the same manner as other abdomi¬ 
nal wounds ; the complication may be an injury to the stomach, 
intestines, liver, kidney, bladder, uterus or any other structure 
located in the abdominal cavity. The severity of the wound 
depends much upon the manner in which the wound was in¬ 
flicted, the amount of damage done to the viscus, and the 
chances of infection. If the injury is within easy access the 
condition is but little worse than a prolapse, but if deep seated 
with several perforations, such as may be caused by a deep punc¬ 
ture, or a gunshot, the condition is very dangerous and usually 
fatal in herbivorous animals, but in carnivora the perforations 
can be as easily located as in man. In the horse or ox the 
