Penetrating gunshot and stab wounds of the abdomen: A review of 336 cases

Joseph E. Hamilton; Ellis Duncan

doi:10.5555/uri:pii:S0039606043904003

Original communication| Volume 13, ISSUE 1, P107-121, January 1943

Penetrating gunshot and stab wounds of the abdomen

A review of 336 cases

Joseph E. Hamilton, M.D.
Joseph E. Hamilton
Affiliations
From the Department of Surgery, University of Louisville School of Medicine Louisville, Ky., USA
From the Louisville City Hospital Louisville, Ky., USA
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Ellis Duncan, M.D.
Ellis Duncan
Affiliations
From the Department of Surgery, University of Louisville School of Medicine Louisville, Ky., USA
From the Louisville City Hospital Louisville, Ky., USA
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DOI:https://doi.org/10.5555/uri:pii:S0039606043904003

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Abstract

1.
1. One hundred ninety perforating gunshot and 146 perforating stab wounds of the abdomen have been reviewed.
2.
2. The mortality for the entire series is 51 per cent for the bullet wounds and 14.1 per cent for the stab wounds. The operative mortality is 48.9 and 13.8 per cent respectively.
3.
3. These observations and analyses are made:
- 3.1.
  a. Incidence of vomiting, pain, spasm, and tenderness in non-penetrating as against penetrating injury.
- 3.2.
  b. The chief causes of death.
- 3.3.
  c. The effect on mortality of age, time from injury to operation, duration of operation, and amount of blood lost.
- 3.4.
  d. The various visceral injuries and their mortality.
- 3.5.
  e. The cause of shock in perforating abdominal injuries. (Primary and secondary shock are differentiated.)
- 3.6.
  f. The outcome of patients operated upon while still in shock.
- 3.7.
  g. Postoperative eviscerations.
4.
4. The following points are particularly emphasized:
- 4.1.
  a. The value of peritoneoscopy in diagnosing peritoneal perforation in doubtful cases.
- 4.2.
  b. Hemorrhage is synonymous with shock in perforating abdominal trauma and therefore operation to control hemorrhage brooks no delay.
- 4.3.
  c. Abdominothoracic injury is more serious than generally realized and ameliorable chest injuries are too frequently overlooked or inadequately treated.
- 4.4.
  d. Autotransfusion, regardless of blood contamination, is urged for all seriously injured patients operated upon within six hours.
5.
5. Treatment is outlined and a few technical details are discussed.

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Article info

Publication history

Received: April 7, 1942

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DOI: https://doi.org/10.5555/uri:pii:S0039606043904003

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