ABSCESS OF THE BOWEL IN SOLIPEDS.
In strangles, from puncture, kicks, blows, foreign bodies in food, larva, cysts, large or small, creamy or cheesy, open into bowel or peritoneum, infective peritonitis. Symptoms: rigor, ill health, unthrift, colics, tender abdomen, tympany, painful movements, lying, rising, turning, going downhill, rectal exploration, phlegmonous swelling, pus passed by anus. Treatment: open when it points on abdominal wall, or when near rectum, antiseptics, support strength, careful dieting, antipuruleut agents.
This is most common as an irregular form of strangles, the abscess forming in connection with the mesenteric glands or on the walls of the intestine. Small abscesses may also implicate the mucous glands or Peyer’s patches as a result of catarrhal enteritis. Less frequently an abscess forms in the seat of the puncture of the colon for tympany, or in connection with blows, kicks, punctures with stable forks, nails and other pointed objects. Foreign bodies entering with the food and the cysts of the larvæ of the sclerostomata will also give rise to suppuration.
These abscesses may attain a large size, especially in strangles, and involve adhesions between the bowel and other viscera, or the walls of the abdomen. Or they may be small like peas or beans scattered along the coats of the intestine or between the folds of the mesentery. They may be inspissated to the consistency of thick cream or rich cheese, and they may rupture into the intestine, through the abdominal walls or into the peritoneum. In the last case infective peritonitis sets in usually with fatal results.
Symptoms. These are generally obscure. There may have been noticed a rigor, and there are always marked indications of ill health, dullness, lack of spirit or appetite, dryness and erection of the hair, hide bound, insensibility of the loins to pinching, colics after meals, tenderness of the abdomen, tympany, groaning when lying down or rising, when turned around short, or when walked down hill. Sometimes the abscess can be distinctly felt by the hand in the rectum. When it implicates the abdominal walls there is usually a diffuse phlegmonous swelling, at first soft and pasty, then firm and solid, and finally softening and fluctuating in the center. Sometimes there is the evacuation of pus by the anus or of the investing membrane of the abscess, and this may be expected to herald recovery. In case of infective peritonitis there are the usual symptoms of stiff movement, the bringing of the feet together under the belly, abdominal tenderness, trembling, hyperthermia, cold ears and limbs, cold perspirations, great dullness and prostration, small, weak or imperceptible pulse, hurried breathing and gradual sinking.
Treatment. This is most favorable when the abscess approaches the surface so as to be punctured through the abdominal walls. In other cases it is so situated that it can be punctured with trochar and cannula through the rectum. In such a case it may be evacuated and injected with a nontoxic antiseptic, the puncture and injection being repeated as wanted. In the internal and deeply seated abscesses we must seek to support the general health, give pure air, easily digestible and nourishing food, and agents that may be hoped to retard suppuration. Hyposulphite of soda in ½ oz. doses, or sulphide of calcium in scruple doses, may be repeated two or three times a day.