Eagle River Democrat. [volume] (Eagle River, Vilas County, Wis.) 1893-1896, 1896-07-13
WOUNDS IN THE ABDOMEN.
There is a Strange Uncertainty About
Intestinal Injuries.

There is Strange Uncertainty About
Intestinal Injuries.
That startling shooting of a bank
president last week, with the suicide of
his assailant later, suggests the uncer-
tainty which always exists in cases OF
wounds of the abdomen. It seems to be
impossible at first to tell how extensively
the patients injury is
In a recent shooting case in New Or
leans the man who was injured had four
teen perforations in his intestines. Yet
he had a good full pulse and did not
seem to be suffering from any special
shock when he was brought into the
hospital to be operated on. Again, some
patients are SO shocked by the occur
renee in which they receive their injury
that they seem to be extremely de-
pressed by the result of a simple acct
dent. A man was brought into the Char
ity hospital in New Orleans with an eX-
ternaI wound in the abdomen. He was
lifted into bed absolutely helpless, and
the physicians thought that they had a
serious gunshot wound of the abdomen.
The man himself feared that death was
imminent.
On examining his clothes the bullet
was found in the leg of his drawers.
The doctors showed it to him and told
him to get up and go home, but he was
unable to get out of bed for hours.
Sometimes bullets go into the 'perito-
neal cavity and do not injure any vital
organ. In the American Journal of Medi-
cal Sciences for May several similar
cases are described. One, a strong man
about 30 years old, was shot, but had no
bad symptoms, and an exploratory oper
alton revealed five bullet wounds in the
small intestine, which were properly
sewed up. During the night the patient
got drunk, got out Of bed and tore off all
no II 111c,0rv lvy II iO6
and it was shown that the wounds in the
intestine had all healed nicely, but
he had infected the outside of his wound
and that killed him. Another man is
mentioned who was shot little above
the navel. An operation showed eight
wounds of the intestine, which were re-
paired, and the patient recovered prompt
ly. Another case was shot in the spleen
and kidney and recovered after opera
ton.
Another case was found to have been
shot through the liver, stomach and into
the intestine. One wound was not
found but the man recovered and was
discharged from the hospital cured in
two months. In the Civil war there
were innumerable such cases, but nearly
all died, because the advancement of an
tiseDtic surgery had not reached point
which made it safe to cut freely into the
patient and hunt up all the places the
bullet had injured.
When the use of antiseptics and steril-
lied instruments and dressings came in a
great advance was made. President Gar
field was shot before this era, and prob
ably lost his life as a consequence.
The rule at present is for surgery al
ways promptly to enlarge the wound and
examine the entire abdominal cavity, to
see if there are not bleeding points in
side, and to see plainly just what the bull
let has and has not penetrated. The OBJ
ject of doing this at once is to try to pre-
vent peritonitis developing from the in
lection of the wound. If the intestine
has been penetrated, some of its contents
will have probably escaped. The way to
prevent this accident causing peritonitis
is to flush out the cavity with many gal
Ions of boiled water, with little salt
dissolved in it. This is done with hot
water for the sake of the tonic influence
to the heart.
If all the wounds have been sutured
and the washing completed satisfactorily,
the external wound can be entirely closed,
or left open for a few days with drain
age tubes.
These cases indicate that if a great
surgeon can see the patient in time a
bullet wound in the abdomen is not the
worst accident that can happen to a man.
Nav York Press