Two cases of gunshot wound of the abdomen : illustrating the use of rectal insufflation with hydrogen gas as a diagnostic measure / by N. Senn.

  • Senn, Nicholas, 1844-1908.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Two cases of gunshot wound of the abdomen : illustrating the use of rectal insufflation with hydrogen gas as a diagnostic measure / by N. Senn. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    ounces of brandy. Foot of bed elevated and ex- ternal dry heat applied. In an hour and a half he rallied somewhat from the operation, but again sank and died at 3 p.m., eight hours after the completion of the operation. Post-mortem eighteen hours after death (Drs. Steele, Gudden, Gordon). Circumscribed peri- tonitis present at time of operating, now diffuse; very little fluid in abdominal cavity; several small blood-clots in vicinity of transverse colon. The per- forations were all securely closed, and the bullet was found in the soft tissues to the right of the spinal column, between the fourth and fifth lumbar verte- brae, and near the ascending colon. The bullet though only of 22-calibre was oblong and may thus explain the unusually large size of the perforations. Remarks.—This case compared with the forego- ing furnishes a strong argument in favor of early operative interference in cases of gunshot or stab wounds of the abdomen in which the existence of visceral lesions can be demonstrated by rectal in- sufflation of hydrogen gas. In the first case, al- though twelve perforations were found and sutured, and fecal extravasation had taken place, no evi- dences of peritonitis were found, and the patient recovered. In this case twelve hours intervened between the time the injury was received and the treatment by laparotomy, during which time a septic peritonitis had developed, the extension of which the operation did not arrest, and from the effects of which the patient died.