. Medical and surgical therapy . es; but, from the point of view of immediate treatment, wecannot conclude from it that a laparotomy has preventive utility;and we do not agree with the advice which Chaput gives, to make asystematic exploratory laparotomy in order to verify the fact ofpenetration. t Four months after a bullet wound Duval (*3) performed resec-tion of the seventh rib, which had been fractured and consolidated;the omentvim which was found beneath the skin adherent to theparietal pleura, was caught in an opening in the diaphragm 2 by 5-6 cm. wide ; after partial resection i
. Medical and surgical therapy . es; but, from the point of view of immediate treatment, wecannot conclude from it that a laparotomy has preventive utility;and we do not agree with the advice which Chaput gives, to make asystematic exploratory laparotomy in order to verify the fact ofpenetration. t Four months after a bullet wound Duval (*3) performed resec-tion of the seventh rib, which had been fractured and consolidated;the omentvim which was found beneath the skin adherent to theparietal pleura, was caught in an opening in the diaphragm 2 by 5-6 cm. wide ; after partial resection it was replaced inthe abdomen through the orifice in the diaphragm ; the splenicangle and the spleen were found adherent to one another; thespleen seemed to have been perforated by a bullet. After sutureof the diaphragm, the thorax was completely closed, and the airin the pleural cavity aspirated. Complete recovery. J See our cases (Figs. 20 and 21) and that of Legrain and Qu6nu,whose drawing we have reproduced (Fig. 22). PLATE I. FiG. A.—Abdomen widely opened, the organs in situ. Betweenthe stomach and the transverse colon, the omentum and the meso-colon tightly joined together, form a thin veil through which areseen several loops of the intestine situated high up.
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectsurgery, bookyear1918
