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October 28, 1905


Author Affiliations


JAMA. 1905;XLV(18):1327. doi:10.1001/jama.1905.52510180043004b

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Patient.  —June 18, 1905, a girl, 13 years of age, while carelessly handling a 22-caliber rifle, shot herself in the abdomen one and one-half inches to the right and slightly below the middle of a line drawn from the umbilicus to the os pubis. She resided at a farmhouse ten miles in the country. Patient had vomited before I reached her, four hours after the accident, and was in considerable pain with limbs drawn up. There was increased pain on slight pressure over the bowels. Considerable shock was present.

Operation.  —Preparation for operation was commenced immediately. Under anesthetic, median incision was made into peritoneum. Considerable free and clotted blood was found, which was scooped out. The first loop of bowel in region of entrance of bullet into peritoneum was grasped, pulled out, and six openings in the small bowel were found in searching nearly its whole length. The openings were

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