History of penetrating abdominal wounds
Keywords:
PENETRATING WOUNDS, ABDOMEN SURGERYAbstract
Throughout history, penetrating abdominal wounds were usually not managed through surgery, and out of luck, a few patients did not die. Ancient Hindus who excelled at sugery, successfully tried to close extruded abdominal internal organs with the heads of giant ants, an art that was lost a few centuries later.
Celso, the great Roman if the 1st Century, provided us with a detailed description of an interventionist treatment and not much happened until the Middle Ages, when Roger of Salerno started sewing internal organs on a small elderberry board. The brave sutures of Ugo Borgognoni, Lanfranco and Henri de Mondeville led Medieval abdominal surgery to is zenith towards the end of the XIV century. Except for a few exceptions, managing wounds through surgery instead of waiting only came true with the pioneer surgeries by Lucien Baudens, Marion Sims, William Mac Cormac, Eugène Chauvel, Félix Léjars and the outstanding Vera Gedrotis, a Russian surgeon and Princess who standed out in the Siberian reality, – among others.The debate came to an end with the great WWI, and as from 1915 exploration was the standard for all penetrating abdominal wounds.
In Uruguay, Justo Duarte’s thesis on this issue illustrates the approach that ruled the country until at least 1892. Seven years after, Luis Pedro Lenguas, Alfredo Navarro and Gerardo Arrizabalaga admitted the convenience of operating such patients.
In the early XX century, Manuel B. Nieto, José Iraola, Domingo Prat, Eduardo Blanco Acevedo and Velarde Pérez Fontana were some of the outstanding surgeons of the new generation who, thanks to their hard work and talent, provided the grounds for modern emergency abdominal surgery in Uruguay.
Since the leading work by Gerald Shaftan, published in 1960, a new policy that classifies patients was created in the scientific world – including our country-, especially those who were stabbed, and systematic laparotomy was no longer the standard. In penetrating wounds caused by firearms the problem has not been solved and there is still no academic consensus on the issue.
References
(2) Loria FL. Historical aspects of penetrating wounds of the abdomen. Int Abs Surg 1948; 87: 521-49.
(3) Celso AC. Los ocho libros de la medicina. Barcelona: Diamante, 1966: 222 v. 2.
(4) Lecène P. L’évolution de la chirurgie. Paris: Flammarion, 1923: 356.
(5) Rutkow I. Surgery. An illustrated history. St Louis: Mosby, 1993: 550.
(6) Pazzini A. Storia della medicina. Milan: Libraria, 1947: 619 v.1.
(7) De Renzi S. Storia documentata della scuola medica di Salerno. Napoli: Nobile, 1857: 499.
(8) Bennet JDC. Abdominal surgery in war. The early history. J R Soc Med 1991; 84(9): 554-7.
(9) Nicaise E. Chirurgie de maître Henri de Mondeville. Paris: Alcan, 296.
(10) Follin E. Plaies d’abdomen. In: Dictionnaire Encyclopédique des Sciences Médicales. Paris: Asselin Masson, 1864: 72-194.
(11) James T. Gunshot wounds of the South African War. S Afr Med J 1971; 45(39): 1089-94.
(12) Smith RC, O’Lear YP. To cut or not to cut. The evolution of exploratory laparotomy for abdominal gunshot wounds. Am Surg 1999; 65(4): 388-9.
(13) Léjars F. Traité de chirurgie d’urgence. Paris: Masson, 1901: 1048.
(14) Praderi RC. El peritoneo, hoy amigo, ayer enemigo. La genialidad de Miculicz. Cir Urug 2005; 75(1): 3-21.
(15) Mac Cormac W. Some remarks by war of contrast on war surgery old and new. BMJ 1901; II: 459-62.
(16) Mac Cormac W. Notes from the South African War. Lancet 1900; (I):58-1486.
(17) Bennet JDC. Princess Vera Gedroits: military sugeon, poet, author. BMJ 1992; 305(6868): 1532-4.
(18) Loria F. Chemotherapy in penetration abdominal gunshot wounds. Surgery 1943; 13: 588-97.
(19) Adams DB. Mandatory exploration for penetrating abdominal wounds. Arch Surg 1991; 126(1): 115.
(20) Shaftan GW. Indications for operation in abdominal trauma. Am J Surg 1991; 126: 115.
(21) Moore EE, Marx JA. Penetrating abdominal wounds. Rational for exploratory laparotomy. JAMA 1985; 253(18): 2705-8.
(22) Saadia R, Degiannis F. Non-operative treatment of abdominal gunshot injuries. Br J Surg 2000; 87(4): 393-7.
(23) Duarte PJ. Pronóstico de las heridas penetrantes de abdomen. (Tesis presentada a la Facultad de Medicina de Montevideo para optar al título de Doctor en Medicina y Cirugía). Montevideo: La Nación, 1892: 92.
(24) Soiza Larrosa A. Médicos uruguayos graduados en Argentina en el siglo diecinueve y sus tesis de doctorado. In: Sesiones de la Sociedad Uruguaya de Historia de la Medicina. Montevideo: Sociedad Uruguaya de Historia de la Medicina, 1992: 50-120.
(25) Mañé Garzón F, Ayestarán A. El gringo de confianza. Montevideo: Impresos, 1992: I-L, 314.
(26) Mañé Garzón F. Pedro Visca. Fundador de la Clínica Médica en el Uruguay. Montevideo: Barreiro y Ramos, 1983: 320 v.1.
(27) Soiza Larrosa A. Medicina y cirugía en las Guerras Civiles Uruguayas de 1897 y 1904. In: Sesiones de la Sociedad Uruguaya de Historia de la Medicina. Montevideo: Sociedad Uruguaya de Historia de la Medicina, 1970-79: 40-159.
(28) Praderi RC, Bergalli L. Notas para una Historia de la Cirugía Uruguaya. Desde la Independencia hasta los principios de este siglo. In: Sesiones de la Sociedad Uruguaya de Historia de la Medicina Montevideo: Sociedad Uruguaya de Historia de la Medicina, 1987: 1-44. t. 3
(29) Pérez Fontana V. La apendicitis. In: Sesiones de la Sociedad Uruguaya de Historia de la Medicina. Montevideo: Sociedad Uruguaya de Historia de la Medicina, 1991: 855. t. 8
(30) Oliver JH. Algunas consideraciones sobre cincuenta casos de heridas de bala. Rev Méd Urug 1899; 2: 3-18, 45-64.
(31) Soiza Larrosa A. La Asistencia Médica Quirúrgica en la Guerra Civil de 1904. Rev Blanca Uruguay (2ª época) 2000; 3: 315-34.
(32) Pou Ferrari R, Mañé Garzón F. Luis Pedro Lengüas (1862-1932). Maestro de cirujanos y precursor de la Doctrina Social Católica en Uruguay. Montevideo: El Toboso 2005: 348.
(33) Lengüas LP. Herida de abdomen con perforación intestinal. Rev Méd Urug 1899; 2: 225-34.
(34) Soiza Larrosa A. Herida y muerte del General Aparicio Saravia. Sesiones de la Sociedad Uruguaya de Historia de la Medicina 1990; 7: 87-116.
(35) Mañé Garzón F. El Cuarteto de Urgencia. Historia de la Cirugía de Urgencia en el Uruguay. 1902-1952. Montevideo: Tradinco, 2005: 256.
(36) Nieto MB. De l’intervention dans les plaies thoraco-abdominales par les vies abdominal, trans chondrodiaphragmatique et trans pleurodiaphragmatique. Rev Gynecol Chir Abdom 1908; 12: 453-68.
(37) Prat D. Casos de cirugía abdominal. Rev Hosp 1912; 5: 662-81.
(38) Prat D. Heridas de abdomen por arma de fuego. An Fac Med Montevideo 1921; 6: 455-73.
(39) Prat D. El ulcus gástrico y duodenal perforados. An Fac Med Montevideo 1922; 7: 101-16.
(40) Iraola J. Heridas penetrantes de vientre. Rev Hosp 1913; 6: 161-75.
(41) Rizzi M. Historia de la transfusión sanguínea en el Uurguay. Rev Méd Urug 1999; 15(3): 13-23.
(42) García Lagos H. Cirugía gastroduodenal, cáncer exceptuado. Primer Congreso Nacional. Montevideo: El Siglo Ilustrado, 1917: 98-124.
(43) Blanco Acevedo E. Asistencia a los heridos en el campo de batalla. An Fac Med Montevideo 1921; 6: 1034-101.
(44) Pelfort C. Fiebre tifoidea con perforación intestinal. Peritonitis. Arch Latinoam Pediatr 1913; 7: 65-75.
(45) Pérez Fontana V. Herida penetrante de abdomen por empalamiento perineal. An Fac Med Montevideo 1923; 8: 22-5.
(46) Mañé Garzón F, Pou Ferrari R. Juan B. Morelli en la medicina uruguaya. Montevideo: El Toboso, 2004: 155-66.
