Diseases of the Stomach and Their Surgical Treatment (Paperback)

Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: CHAPTER III INJURY OF THE STOMACH Wounds of the stomach may be incised, lacerated or gunshot. Incised (punctured) wounds are caused by stabs with sharp-pointed instruments of metal or wood. Lacerated wounds are the result of severe contusions, kicks, blows with the fist, falls, or buffer accidents. The stomach is less frequently injured than the intestine, owing to its protection by the chest-wall and liver. The stomach may also rupture spontaneously or by injury from within. A wound of the stomach may involve the mucous coat alone, the mucous and muscular, the muscular and serous, the serous alone, or all the coats; it may or may not be associated with a wound of the abdominal wall, and may be found on either the anterior or the posterior surface. The symptoms will vary according to the nature and extent of the wound. If the mucous surface alone is wounded, gastror- rhagia of greater or less severity will be noticed. In some cases there has been copious vomiting of bright arterial blood, showing that a vessel of some size has been wounded. If the serous coat alone is torn, there will be a localized peritonitis, which may possibly lead to a perigastric abscess. If a complete solution of all the coats occurs, the symptoms and signs will depend in some degree upon the amount and character of the food present in the viscus. If the stomach be empty, the extravasated fluid will consist of gastric juice, with remnants of food and mucus, and it will be, comparatively speaking, innocuous. If the stomach be laden with recently-acquired food, the material escaping into the peritoneal cavity will be abundant in quantity, andwill contain various forms of micro-organisms. Septic peritonitis will result in either case, but the measure of its virulence will depend upon the quantity and ch...