History of penetrating abdominal wounds

Abstract

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.