692 
DEPARTMENT OF SURGERY. 
ligature around tlie ovarian ligament and arteries 5 the haemor¬ 
rhage following such a procedure is generally fatal. The 
proper way to remove them is by torsion, which invariably 
prevents haemorrhage. 
(^0 Peritonitis. —This is not a very common sequel ; but 
does occasionally follow gross neglect of cleanliness, such as 
the introduction of dirt into the cavity through the abdominal 
incision during the operation. Septic peritonitis may result 
from secondary abscesses which occasionally occur along the 
course of fistulae located between the muscular coat and the 
peritoneum, and “ break open ” into the peritoneal cavity—the 
direction of least resistance—emptying their contents into the 
cavity. These fistulae usually originate in sinuses or pockets 
in the lips of the surgical wound which were not properly 
treated before suturing the wound. Peritonitis seldom follows 
the operation except from these two accidents. 
Complications.— The complications that may interfere with 
the operation or make the location of the ovaries difficult can 
be considered in the following order : 
(» Protrusion of intestine. 
(b) Distended bladder. 
O) Rupture of the bladder. 
(a) Protrusion of the Intestine usually occurs during the 
withdrawal of the horns and ovaries from the cavity ; and in such 
cases the operation should be suspended until they are returned 
into the abdomen. This is sometimes a difficult task, espe¬ 
cially when the intestine is tympanitic. As soon as they are re¬ 
turned the operation should be continued. In case of tympan¬ 
ites or when the intestine is filled with aliment, the location of 
the ovaries is made difficult by being crowded from their normal 
position, and for this reason it is absolutely necessary that 
sows that are to be spayed should not be fed during the last 
twenty-four hours prior to the operation. 
(^b) Distended Bladder. —A distended bladder crowds the 
intestine through the incision ; changes the relation of the 
uteius and its horns and ovaries ; and, like tympanites and loaded 
intestine, makes the location of the structure almost impossi¬ 
ble, and even when found it may be a difficult task to draw 
them out of the cavity. When the bladder is distended it is 
necessary to empty it before proceeding any farther with the 
operation ; this can be done by placing the hand upon the re¬ 
gion of the bladder and applying gentle pressure. 
(V) Rupture op the Bladder. —The bladder when distended 
