Report on Orthopedic Surgery

1899 Boston Medical and Surgical Journal  
wards as one of obstruction of the bowel, and I found nothing except some contracted bowel. I examined tho bowel till I came to the duodenal end, then 1 worked back, and at the large intestine came across a constriction which would admit a small lead pencil. a vessel, when a spar fell upon him and smashed in his pelvis. Unconscious for a short time and nauseated ; be came into the hospital at once and was catheterized, urine mixed with blood being found in the bladder. He had a good pulse, but
more » ... ooked rather knocked out. He was let alone for an hour or two, when the catheter again drew urine and blood, but, as the pulse was worse, a laparotomy was performed at once. The hemorrhage was all iu front of the peritoneum from the umbilicus to the pelvis, pushing the peritoneum back against the spine. There was no hemorrhage into the abdominal cavity ; it was entirely pro-peritoneal and pretty severe for a time, apparently coming from the deep epigastric and the space of Retzius. Packing controlled the hemorrhage. There was leakage of urine through the wound in a few days. Wo tied in a catheter, but at the end of three weeks he was still passing urine out through the wound. An external urethrotomy was done, after which he healed up rapidly, and went out at the eud of three months well, and he has been at his work ever since. It is interesting because of the exceptionally large amount of hemorrhage that took place iu front of the peritoneum. PENETRATING WOUND OF THE RECTUM AND PERI-TONEUM.
doi:10.1056/nejm189903021400904 fatcat:wkvtnw65p5cwtlkzzz7ed7sn4m