Sand, pebbles, earth, lime, nails, pins, needles, coins, shot, cloth,
leather, rubber, sponge, tooth, bone, wood, twine. Symptoms: as in
intestinal indigestion or calculi, or sand or pebbles in fæces;
peritonitis, phlegmon. Lesions: congestion, catarrh, ulceration,
abscess, needles may travel to other organs. Treatment: laxative,
enemata, or as for calculi.
All sorts of foreign bodies are taken in with food and water and find
their way to the intestines. Sand from drinking from shallow streams
with sandy bottoms, from browsing on sandy pastures where the vegetation
is easily torn up, or from feeding grain from sandy earth will sometimes
load the intestines to an extraordinary extent so that such horses will
pass sand for some weeks after leaving the locality. Small stones and
gravel are taken in in the same way or from the habit of eating earth or
licking crumbling lime walls. Nails, pins, needles, coins, shot, pieces
of cloth, leather, caouchouc, sponge, and even a molar tooth and a piece
of a dorsal vertebra have been thus taken. Recently the author saw a
small twig of hard wood transfixing the pylorus and duodenum with fatal
effect. In another case were balls of binding twine which had been taken
in with the fodder on which it had been used.
The _symptoms_ are usually those of intestinal indigestion or calculi.
In some cases, however, they are peculiar, thus there may be a constant
passage of sand, there may be indications of peritonitis, or there may
form a phlegmonous swelling of the abdominal walls in the abscess of
which the foreign body is found.
_Lesions._ Pechoux found 56 lbs. of a brownish earth in the cæcum and
colon. Congestion and ulceration of the intestines are common, with
occasionally abscess. All the lesions that attend on or follow
obstruction may be met with. Boullon saw a remarkable case of the
ingestion of needles in which these bodies were found in the small
intestine, liver, pancreas, diaphragm, kidney and lung.
_Treatment_ varies with the character of the bodies ingested, sand and
gravel may be passed on by a laxative diet and even by the use of mild
laxatives. Bernard gave 10 quarts of water and 4 oz. Glauber salts every
hour for eight days, and the same amount by enema. For the larger solid
bodies which obstruct the intestines the treatment is the same as for
calculus. For sharp pointed bodies causing abscess and fistulæ, we must
follow the indications, ever aiming at the discovery of the whereabouts
of the offending object and its removal.