The rectum and anus : their diseases and treatment.

  • Charles Bent Ball
Date:
[1887]
Catalogue details

Licence: Public Domain Mark

Credit: The rectum and anus : their diseases and treatment. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    Chap. XXIX.] Gunshot Wounds: Statistics. 3S9 Otinsliot wounds—Dr. J. Marion Sims has pointed out* tliat bullet wounds of the pelvis, even when passing through rectum, bladder, and peritonaeum, are by no means ab.solutely fatal injuries; and he makes a very forcible contrast between these and per- forating wounds of the abdominal cavity. Of seven of the former occurring within his knowledge at Sedan, all recovered, while seven of the latter all proved fatal. Of gunshot wounds of the rectum during the American War, Otisf collected 103 cases with a fatality of 42-7 per cent.; in 34 of these the bladder also was wounded, with a mortality of 41 17 per cent. Dr. Sims attributes the more favourable result in pelvic injuries to the fact of free drainage. When the abdominal cavity is perforated fluids collect in the pelvis, become septic, and lead to a fatal result; but where a man is shot through the pelvis efficient drainage is more likely to result. Of the incised wounds resulting directly from operation it is not necessary to speak. Accidental wound of the rectum during the per- formance of lithotomy does not generally prove trouble- some, owing to the free drainage from the wound. In a few cases, however, recto-urethral fistulas have been established. A consideration of the histories of rectal injuries shows that where the wound is extensive, and consequently drainage free, the prognosis is tolerably good ; whereas punctured wounds in which the con- ditions of free drainage are not found are apt to be followed by putrid emphysema, extravasation of f?eces, diffuse inflammation, and other more serious septic complications. Mr. Bryant records a case| in which a boy, aged twelve years, was impaled on some * British Medical Journal, Februfiry 18, 1882. t Aslihurst, Encycloppediaof Surgery, vol. ii. p. 199. X Medical Times and Gazette, May 25, 1878.