Intestinal surgery / by N. Senn.

  • Senn, Nicholas, 1844-1908.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Intestinal surgery / by N. Senn. Source: Wellcome Collection.

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    opened was found almost completely filled with blood. The source of this profuse haemorrhage was the right kidney which showed a perforation through the centre. An examination of the gastro-intestinal canal revealed two perforations of the caecum, and five, of the small intestines. After passing through the kidney the bullet perforated the diaphragm, traversed the pleural cavity, and escaped through the chest wall two inches (5 cm.) to the right of the spine. Experiment 63. Old dog, weight thirty-five pounds. Thoroughly etherized and shot in the abdomen, the bullet entering three inches (7.6 cm.) to the right of, and an inch and a half (3.8 cm.) below the umbilicus, passing almost trans- versely through the abdominal cavity and escaping at a corresponding point on left side. Inflation of hydrogen gas was attempted, but failed on account of the apparatus being out of order. The abdomen was opened and no gas was found even in the colon. Twelve perforations of the small intestines were found, and a number of perforations of the mesentery, whioh had caused pro- fuse haemorrhage. Experiment 64. Large, black dog. Etherized and shot in the abdomen; wound of entrance three inches (7.6 cm.) to the right of, and an inch and a half below the umbilicus; wound of exit near a corresponding point on opposite side, the bullet taking nearly a transverse course. Rectal inflation of hydrogen gas gave a prompt positive result. The abdomen was opened and five perforations of small intestine were found, besides laceration of thoracic duct, and a number of perforations in mesentery. Colon and small intestine below the lowest point of perforation contained gas, while above the lowest perforation the bowel contained no gas. Experiment 65. Dog, weight twenty-five pounds. Under full anaesthesia the animal was shot in the abdomen, the bullet passing in a nearly transverse direction through the abdominal cavity an inch and a half below the umbilicus from point of* entrance; wound of exit midway between linea alba and spine. Rectal insufflation of hydrogen gas made under very low pressure, led to rapid distention of the abdomen, an occurrence which furnished strong evidence that the gas had escaped through a perforation in the colon into the peritoneal cavity. The gas escaped in bubbles through the wound of entrance, and when a lighted taper was held near the wound, it burned with a jet vary- ing in size. On opening the abdomen gas escaped from the peritoneal cavity; small intestines empty, and only a small amount of gas in the colon. The following intra-peritoneal injuries were found: Four perforations of the duodenum, two of the jejunum, and one of the caecum; also a perforation nearly through the centre of the left kidney, laceration of the reoeptaculum chyli, and a number of perforations in the mesentery. The bullet was found between the left kidney and the abdominal wall. In aU of these experiments the bullet was fired through the abdomen from side to side transversely, or somewhat obliquely, directions which invariably brought into the track of the bullet a number of intestinal coils, and often the colon. In the two expen-