Gunshot injuries : how they are inflicted : their complications and treatment . staff of A Civilian WarHospital. The authors quote the case of Mr. Lenthal Cheatle as fol-lows: A private was shot right across the abdomen in a fight to thewest of Pretoria, and died forty-eight hours later. The bullet had enteredlow down in his right lumbar region, and had emerged near the leftanterior superior spine of the ilium, where it finally lodged, after pass- 254 GUNSHOT WOUNDS ing through the skin for half its length; it was a Jeffreys sportingbullet. The post-mortem examination showed that the projectil
Gunshot injuries : how they are inflicted : their complications and treatment . staff of A Civilian WarHospital. The authors quote the case of Mr. Lenthal Cheatle as fol-lows: A private was shot right across the abdomen in a fight to thewest of Pretoria, and died forty-eight hours later. The bullet had enteredlow down in his right lumbar region, and had emerged near the leftanterior superior spine of the ilium, where it finally lodged, after pass- 254 GUNSHOT WOUNDS ing through the skin for half its length; it was a Jeffreys sportingbullet. The post-mortem examination showed that the projectilehad passed through the cecum transversely, close to its posterior wall,and had passed out through the sigmoid flexure, in which it made alarge rent. It was thus clear that the bullet had passed right acrossthe cavity of the abdomen, and, having entered it posteriorly andpassed from behind forward, it had thus traversed the abdomen in itsantero-posterior diameter as well. In spite of this, however, the coilsof small intestines showed no wound or abrasion, although there was. Fig. 122.—Knuckle of gut from wound of entrance and omentum from wound of exit in Thornburgh case. a most careful search after removing the bowels from the cases might be quoted, but this one is enough to establish be-yond doubt the possibility of a bullet traversing the abdominal cavitybelow the umbilicus without wounding the small intestine. From the foregoing it may be taken for granted that when a bullettraverses the intestinal area without the appearance of symptoms ofperitonitis the small intestine has escaped perforation. GUNSHOT WOUNDS OF THE ABDOMEN 255 (4) Perforating Gunshot Wounds of the Abdomen.—In this classof wounds the peritoneum is not only opened but there is lesion ofsome of the contained viscera. Pathology.—The wound of entrance is more often located on theanterior surface of the abdomen and this is especially true of woundsmet in civil hospitals from personal combat. Le
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