. Medical and surgical therapy . (blood, intestinal con-tents, etc.). jectiles. If the passage of communication with theexterior in the sacro-coccygeal region is widely openedwe can observe the progressive cicatrisation of therectal wound. The same remarks may be appHed to the bladder :in wounds of the same degree the gravity is manifestlygreater in lesions which aliect the peritoneal nevertheless observe spontaneous heahng of per-fofations of the bladder by bullet, shrapnel, or smallprojectile entering the suprapubic or transpubic part. 354 WOUNDS OF THE ABDOMEN Sometimes the bladde
. Medical and surgical therapy . (blood, intestinal con-tents, etc.). jectiles. If the passage of communication with theexterior in the sacro-coccygeal region is widely openedwe can observe the progressive cicatrisation of therectal wound. The same remarks may be appHed to the bladder :in wounds of the same degree the gravity is manifestlygreater in lesions which aliect the peritoneal nevertheless observe spontaneous heahng of per-fofations of the bladder by bullet, shrapnel, or smallprojectile entering the suprapubic or transpubic part. 354 WOUNDS OF THE ABDOMEN Sometimes the bladder is obliterated at once, andthe cidatrisation proceeds plane by plane ; sometimesfistula of the passage, purely urinary, or pyo-urinar>%is set up as an intermediate condirion. Cases of thiskind are not extremely rare. One observation is applicable to all the pelvic organs,and to the iliac cavities and the hypogastrium. Allintra-abdominal effusions have a general tendency todescend towards the pelvis,which thus plays the part. Fjo, g.—^The pelvis is the collecting-sink of the p«itonealcavity, particularly in Foi«^er*s position. of a true collecting-sink. The organs situatedlow down that we are now considering are evidentlyplaced in privileged conditions, as blood or faecalmatter coming from their perforations will proceedto the collecting-sink without traversing or infectingthe general peritoneal cavity (see Figs. 7 and 8). We have now analysed the anatomical conditions inwhich the different viscera, considered separately, areHkely, when involved by a penetrating abdominalwound, to heal spontaneously—that is to say, to benefitby abstention. ANATOMICAL LESIONS ;3r,.-i The chances of healing vary with the different poor in the case of the intestine, they are consider-able, in comparison, for the liver, the stomach, andthe ascending and descending colon. To sum up : Spontaneous healing of the small intestineis exceptional—it is a risk that would not justify
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1918
