(1.) Some authors recommend grasping the two ends, drawing them apart, and thus reducing the invagination. The actual manœuvre is not difficult, but even when unattended by accident or tearing of the intestine it is by no means always followed by recovery. Although the intestine may not appear gangrenous externally, necrosis often occurs eventually.
This method should only be practised during the first twenty-four hours after the appearance of colic, and even then one must always bear in mind the possible consequences just mentioned, and the chances of rapidly fatal septic peritonitis.
(2.) The second method consists in removing the invaginated portion of intestine. It is best to apply bichromatised catgut or silk ligatures to all the arteries which pass from the mesentery into the loop to be removed; after which the loop itself may be simply divided an inch or two above and below the invagination, in order to be quite certain that one is operating on healthy tissue, the divided ends being held meanwhile by an assistant. The intestine is afterwards sutured with a fine needle and bichromatised catgut or boiled silk. The form of suture will be found described in Dollar’s “Operative Technique.” It may be valuable to test the efficacy of decalcified bone tubes for uniting the ends of the intestine.
The operation is long, delicate and difficult, and it is imperative not to infect the abdominal cavity during its performance. To prevent this the liquid and solid materials present in the bowel may be thrust upwards and downwards away from the diseased part before the section is made; and in this way the wound and the operator’s hands are preserved from infection. The intestine should be kept closed during the application of sutures by means of flat clamps cautiously applied. In their absence the ends may be held by an assistant, whose hands should previously have been carefully disinfected.
(3.) In cases where the serous coats of the two portions of bowel constituting the invagination are to some extent adherent, another operation of a less perilous character may be performed. This consists in liberating the invaginated part by means of longitudinal incision, without previously disengaging the parts, and without resection. The invaginated (external) portion of intestine is divided longitudinally; the gangrenous part immediately becomes visible, and may be removed. The operator has then only to suture the longitudinal wound, an operation which is much easier and demands much less time than any circular intestinal suture whatever. These operations must not be attempted except in response to the express wish of the owner, who should be fully informed of the dangers to which they expose the animal; for after the second day of invagination local peritonitis has often developed and one is then operating on injured or infected tissues, in itself a very unfavourable modifying condition. The current formula that “the operation was very successful” is not accepted in veterinary practice when the patient dies three or four days afterwards. From the economic standpoint it is better to slaughter animals of any value, for unless secondary peritonitis has occurred, and the animal is not feverish, the meat is fit for consumption. “Volvulus,” or twist of the intestine, is said to be almost unknown in cattle, though Reichert records a case of volvulus of the ileum.
COLIC AS A RESULT OF STRANGULATION.
The symptoms of this colic differ very little from those of the preceding with which they are often confused. But in regard to its causation the condition is essentially different.
Causation. Strangulation of the intestine in the ox may be produced in several different ways: by the passage of a loop of intestine through a tear in the epiploon, through the diaphragm, mesentery, broad ligament of the uterus, the serous layer surrounding the spermatic cord, etc., or by strangulation of an intestinal loop by fibrous bands resulting from chronic peritonitis, etc. Of these various causes, the three principal may here be described:—
(1.) Tearing of the mesentery. As a result of mechanical violence the epiploon or mesentery becomes fissured, and the peristaltic movements cause a loop of intestine to pass through and become fixed in the fissure. If the opening is narrow, as is usually the case, the base of the intestinal loop, riding on the lower lip of the slit, becomes constricted by the margins of the opening through which it has passed.
