Urethral Calculi

Urethral Calculi

Urethral Calcui£. 3 impossible to dissect and separate away by themselves the lips of the wound in the cesophageal parietes-so as to allow them to b...

595KB Sizes 0 Downloads 60 Views

Urethral Calcui£.


impossible to dissect and separate away by themselves the lips of the wound in the cesophageal parietes-so as to allow them to be distinctly and satisfactorily stitched together. I believe cesophagotomy has been successfully performed in the horse, ox, dog, and pig. In man the operation has been performed eleven times, and only twice did death supervene, -so that nine human lives have been snatched from death by cesophagotomy. In the recently published work on "Veterinary Surgery" by MM. Peuch and Toussaint, a very interesting chapter on this subject will be found; these authors recommend the cautious and " bit by bit" manner of operating-precisely as done by Dr. Hirschfeld in the above case. Peuch and Toussaint say they have operated twice on dogslosing one case and saving one. During the last thirteen years I have met with several cases of dilatation of the gullet (in young horses), immediately in front of the sternum; and in three of these cases, as a dernier ressort, I cut into the cesophagus: one case did well, but the other two succumbed. In one case the distension was so great, that when I cut open the cesophagus, I extracted more than a bucketful of ingesta from the dilatation per the wound! In the latter instance, the cesophageal parietes were very much attenuated, and very white and blanched looking. During the past summer I met with a case of congenital cesophageal dilatation in a foal; here the distension of the gullet extended more than half way up the neck from the stemmn ,. and, from the symptoms presented, I am almost certain this abnormal state of matters was continued from the sternun:l to the cardiac orifice of the stomach. I tried bandaging, pads. and everything I could think of, with little, if any, benefit; the patient is, however, still alive.


SOME time ago, a farmer from a distance requested me to see a horse of his, which had passed very little urine for more than


The Veterinary


thirty-six hours, notwithstanding the administration of liberal doses of saltpetre and sweet nitre. On my arrival I found the patient exceedingly uneasy, abdomen evidently distended, the urethra prominent and full along its visible course, and an occasional drop of urine escaping from it. It was plainly a case of urethral obstruction; and I prepared at once to pass the catheter, as, from the condition of the patient, rupture of the bladder might occur at any moment. On attempting to do so, however, I found, firmly fixed in the urethral tube, and almost completely blocking it, a large, hard, smooth calculus. As it was low down, I attempted to extract it by means of the forceps, but, from its great volume and hardness, it could neither be taken out whole nor reduced in size. The knife was then the only alternative; and as no time was to be lost, I determined to operate with the patient standing. By two careful incisions in the urethral tube, the calculus was removed, and with it escaped the urine in the urethra. Immediate relief was apparent; but the bladder having become paralysed from overdistention, it was necessary to evacuate that viscus by means of the catheter. The horse made an excellent recovery. With regard to the calculus itself (a very large and fine specimen), the patient unfortunately stepped on and injured it. The remainder, however, which shows clearly the great size of the concretion originally, has been presented to the museum of the Ontario Veterinary College. This case forms an excellent commentary on the use, or rather the abuse, of diuretics by non-professional gentlemen. It also shows the importance of operating in some cases with the patient standing: had this animal been cast, the bladder would almost inevitably have been ruptured. This is only the second case of urethral calculus occurring in a practice of seven years; the other being that of a ram. In the latter case, the calculus was exceedingly small; it was discovered in the vermiform appendix, and removed. Unfortunately, rupture of the bladder had already taken place. This specimen I also presented to the Ontario College.