PERFORATING ULCER OF THE STOMACH
Causes: round ulcer, foreign bodies, parasites. Symptoms: those of ulcer, followed by infective peritonitis, fistula, pleuritis, pericarditis. Treatment: of fistula.
This may be the result of the gradual deepening of the round ulcer, yet in the domestic animals it mostly comes from the presence of sharp pointed bodies. These may be enumerated as needles, pins, nails, wires, sharp bones (dog), whalebone (horse), forks, knives (cattle), and even gravel. The burrowing of the spiroptera has seemed to cause perforation in the horse. All causes of ulceration may, however, lead to perforation.
The symptoms are those of gastric ulcer, already given, followed by the more specific ones of perforation. These in their turn differ according to the parts involved. In the horse and dog the perforating ulcer usually opens into the peritoneum, inducing a fatal infective peritonitis. In cattle the foreign body sometimes passes toward the heart, enveloped in a protecting mass of new formed tissue and proves fatal by heart disease. In other cases it has been found to proceed downward toward the sternum and to escape by a fistula formed beside the ensiform cartilage. In other cases it has taken a direction toward the right wall of the abdomen where it formed a fistula, discharging alimentary matters. In still other cases it has opened into the peritoneal cavity with fatal effects.
Treatment in the case of external fistula, without implication of the peritoneum, consists in the removal of the foreign body, and the stimulation of granulations along the tract of the fistula by the application of an ointment of tartar emetic to the interior. Should this fail the fistulous tract may be scraped to make it raw, and the edges may then be drawn together with sutures taking a deep hold of the skin.