FOREIGN BODIES IN THE RUMEN AND RETICULUM.
Common. Harmless or injurious. Perforating objects. Traumatisms of contiguous organs. Causes; hurried primary mastication, morbid appetite. Bodies found. Lesions; catarrh, perforations, congestions, ulcerations of mucosa, abscess, trauma of liver, spleen, diaphragm, abdominal and thoracic walls, lung, pleura, pericardium, heart. Symptoms; absent, or, indigestion, tympany, eructations, hepatic, respiratory or circulatory disorder, colics, local tenderness, crepitation, substernal exudate, costiveness, difficult urination or defecation, bloody fæces, nervous disorder. Treatment; Prevention; avoidance of causes, gravitation methods, incision.
These are so frequent that they can hardly be looked on as abnormal, but they must be accepted as pathological when they cause serious irritation or digestive disorder. This result is seen especially in the case of cutting or sharp pointed bodies, which beside wounding the walls of the rumen, show a marked tendency to advance to the heart and penetrate it, or to perforate the liver, diaphragm or abdominal walls and even to cause a fistula through which the ingesta escapes.
Causes. The common cause in cattle is the habit of swallowing, after one or two strokes of the teeth, any small object that is mixed with the provender. Next to this comes the habit of stabled cows, and of such as suffer from a lack of phosphates or other important element in the food, of licking, chewing, and swallowing articles that can in no sense be considered as alimentary.
Among the rounded or smooth bodies found in the rumen and reticulum may be named coins, rivets, fragments of wood, cords, pieces of rope, leather, gloves, cloth, small garments like vests or caps, ribbons, bones, pieces of lead, dried paints, cotton waste used as packing for machinery, shot, and even small animals such as frogs, toads, and snakes; also sand and pebbles.
Among sharp or pointed bodies the most common are nails, pins, needles, baling wire, pieces of iron or other metals, knives, scissors, forks, fragments of glass, thorns, etc.
Lesions. These are as varied as the nature of the traumatic agent, the seat and nature of the trauma. The rounded bodies, if non-poisonous, act merely by attrition of the walls and tend to induce a local catarrhal inflammation. Yet even sharp pointed bodies may prove comparatively harmless. The museum of the N. Y. S. V. College contains a pocket knife which had remained open in the rumen for a length of time without producing any visible injury.
Sharp and pointed bodies are especially liable to be entangled in the cells of the reticulum; so that this viscus is the most common seat of the resulting trauma. Around this there occur hyperæmia, exudation, thickening and centrally ulceration, which may lead into a fistula or abscess, confined it may be to the wall of the viscus, or continued into the surrounding organs. In this way may be implicated, the liver, the spleen, the diaphragm, the abdominal or thoracic walls, the lung, the pericardium or the heart. The pus is always fœtid and usually mixed with alimentary matter. If it approaches the surface it may burst and allow exit to the offending body. If it encroaches on the liver, symptoms of hepatic disorder supervene. Its progress through the lung or pleura is marked by objective symptoms of pulmonary or pleural inflammation (crepitation, flatness or percussion, creaking or friction sounds), but without the customary amount of hyperthermia, and with some evidence of gastric disorder. When the pericardium is reached there are the usual signs of pericarditis, attended by comparatively little fever, and a doughy swelling beneath the sternum is added to the objective signs of exudation in the pericardium.
Among the peculiar routes followed by such bodies may be named the following: to the side of the ensiform cartilage; through an intercostal space; into a chondro-costal articulation; through the muscles of the flank; and even in the region of the croup. If the attendant abscess or fistula bursts into a serous cavity it determines septic peritonitis or pleurisy, while in the lung it may cause septic pneumonia. As a rule, however, this is prevented by the excessive quantity of exudation.
Symptoms. These are extremely variable according to the seat and nature of the lesion. So long as the foreign body is confined in the rumen there is usually no symptom. Even when it has penetrated surrounding organs the symptoms are usually for a time very obscure. A few years ago a cow entered the prize ring, at the New York State Fair, was awarded first prize, and died a few minutes later from a piece of baling wire penetrating the pericardium. When symptoms are patent there are usually early indications of indigestion in the rumen, capricious appetite, sluggish and imperfect rumination, dullness, tardy movements, frequency and fœtor of eructations, colicy pains, grunting when moved, and wincing under pressure in the left hypochondrium. Pressure below, to the left of the ensiform cartilage is sometimes particularly painful.
If the object is advancing toward the heart a broad area or line of dullness may often be detected by percussion on the left side of the chest and under the acts of respiration or walking, gurgling sounds may be heard along this line. The movements of the ribs on the same side are limited as compared with the other side, and straining in defecation or urination may be manifestly painful and accompanied by groaning. For the same reason costiveness is liable to set in.
When the body approaches the skin there is formed a large, hot, phlegmonous swelling similar to that which marks the advance of an intercostal abscess.
In special cases there are symptoms of disease of the particular organ penetrated. Hepatitis, splenitis, and peritonitis are occasionally seen. Eggeling notes a fatal hemorrhage from the wounding of the œsophagus by a nail, and Brauer bloody fæces from penetration of the pylorus by a piece of glass. In other cases fatal results have followed on trauma, thickening and obliteration of the pylorus. (Olivier).
In cases of the ingestion of shot, the spray of bullets, white or red paint or other form of lead, the special symptoms of lead poisoning supervene. (See lead poisoning).
Treatment. As a rule this is unsatisfactory and especially in cases implicating the pericardium, as the symptoms may be entirely overlooked until sudden death occurs. Hence the great value of preventive measures, and above all the careful removal of all nails from the vicinity of fodders. Bailed hay is always dangerous, and when used, each bale should be carefully freed from its wires and any short pieces removed. Pointed metallic bodies of all kinds should be removed from the pastures and stables.
In case the migrating foreign body leads to the formation of a superficial phlegmon at any point, this should be freely opened and the offensive agent extracted.
If the lesion in the reticulum has been diagnosed, the combined methods of Kolb and Schobert should be tried. Turn the animal on its back with the head and shoulders up hill, and employ strong pressure, with the foot, in jerks, over the ensiform cartilage. The object is to slide the foreign body back into the viscus, and success is claimed in seven cases out of nine.
Failing in such methods there remains only the operation of rumenotomy and the removal of the offending bodies so far as they can be reached.