Third stage. Puncture of the blind end of the colon, and suture of the latter to the cutaneous wound, as in the former case.
A third condition may exist, where the extremity of the colon remains within the abdomen. Operation by way of the pelvis then proves unsuccessful. If considered advisable, an opening may be made through the right flank, so that the floating colon may be brought to the surface and an artificial anus produced in this region.
An incision 1 or 2 inches in length is made below the haunch, to allow of the introduction of the index finger, with which the loop is sought. The colon is withdrawn, and the operation thenceforth is as above described.
PROLAPSUS AND INVERSION OF THE RECTUM.
This condition occurs in young pigs in various degrees. The necessity for reduction depends on the extent to which tearing or gangrene of the mucous membrane has progressed. The inverted portion is carefully washed, freely dressed with some non-irritant fatty substance such as vaseline, and progressively pushed back with the thumbs and index fingers of both hands applied flat on either side of the anus. To facilitate reduction it is best to check the animal’s expulsive efforts by placing a gag in the mouth.
In more aggravated cases, when prolapsus of the rectum has returned several times and the mucous membrane is gangrenous in places so that such a complication as peritonitis of the pelvic cavity is to be feared, it is better to amputate the prolapsed portion.
The animal is secured either standing or lying down, and a large enema is administered to remove the contents of the rectum. The herniated portion of bowel is carefully examined, for it sometimes happens that loops of intestine have become lodged in the dilated peritoneal sac, produced by displacement of the rectum. In such cases reduction should be effected before anything more is done, and for this purpose the patient’s hind quarters should be lifted or even suspended.
The operation for removal comprises two stages:
(1.) Fixation of the two layers of bowel by the passage of either two or four sutures about ½ an inch behind the anus.
(2.) Circular amputation of the sutured tissues; insertion of interrupted silk sutures through the lips of the wound; reduction. The patient is restricted to milk diet for a week. Laxative gruels, etc., may then be given.