FOREIGN BODIES IN THE INTESTINES OF SOLIPEDS.
Sand, pebbles, earth, lime, nails, pins, needles, coins, shot, cloth, leather, rubber, sponge, tooth, bone, wood, twine. Symptoms: as in intestinal indigestion or calculi, or sand or pebbles in fæces; peritonitis, phlegmon. Lesions: congestion, catarrh, ulceration, abscess, needles may travel to other organs. Treatment: laxative, enemata, or as for calculi.
All sorts of foreign bodies are taken in with food and water and find their way to the intestines. Sand from drinking from shallow streams with sandy bottoms, from browsing on sandy pastures where the vegetation is easily torn up, or from feeding grain from sandy earth will sometimes load the intestines to an extraordinary extent so that such horses will pass sand for some weeks after leaving the locality. Small stones and gravel are taken in in the same way or from the habit of eating earth or licking crumbling lime walls. Nails, pins, needles, coins, shot, pieces of cloth, leather, caouchouc, sponge, and even a molar tooth and a piece of a dorsal vertebra have been thus taken. Recently the author saw a small twig of hard wood transfixing the pylorus and duodenum with fatal effect. In another case were balls of binding twine which had been taken in with the fodder on which it had been used.
The symptoms are usually those of intestinal indigestion or calculi. In some cases, however, they are peculiar, thus there may be a constant passage of sand, there may be indications of peritonitis, or there may form a phlegmonous swelling of the abdominal walls in the abscess of which the foreign body is found.
Lesions. Pechoux found 56 lbs. of a brownish earth in the cæcum and colon. Congestion and ulceration of the intestines are common, with occasionally abscess. All the lesions that attend on or follow obstruction may be met with. Boullon saw a remarkable case of the ingestion of needles in which these bodies were found in the small intestine, liver, pancreas, diaphragm, kidney and lung.
Treatment varies with the character of the bodies ingested, sand and gravel may be passed on by a laxative diet and even by the use of mild laxatives. Bernard gave 10 quarts of water and 4 oz. Glauber salts every hour for eight days, and the same amount by enema. For the larger solid bodies which obstruct the intestines the treatment is the same as for calculus. For sharp pointed bodies causing abscess and fistulæ, we must follow the indications, ever aiming at the discovery of the whereabouts of the offending object and its removal.