Historical and medical overview of treating abdominal gunshot wounds

Abstract

The historical and medical review of the treatment of abdominal gunshot wounds clearly showed that the earliest data of the problem under consideration in the sources date back to the period of the Crimean War (1853-1856) [7]. The design of tactics for the treatment of abdominal wounds is presented in the historical aspect: from expectant conservative management to active surgical treatment, and to the current stage of knowledge and the level of surgery development. It has been found that this is the most severe category of patients with high rates of mortality and complications that require early and complete surgical treatment and prevention of the development of multiple organ dysfunction syndrome. The foundations for organizing surgical care for the wounded were laid by N.I. Pirogov, who devoted a separate chapter to wounds of the abdominal cavity in the Principles of General Military Field Surgery [7]. During the First World War, German, French, and Russian surgeons, completely independently of each other, advanced from conservative to surgical treatment, which was a major milestone in the evolution of the doctrine of abdominal gunshot wounds. The work of Soviet military surgeons in the field to provide assistance to the wounded in the abdomen during the war with the White Finns for the first time confirmed the possibility of a wide application of the surgical treatment method for an abdominal gunshot wound [8]. The absolute advantage of the surgical method used in the Great Patriotic War of 1941-1945 was confirmed. The historical and medical experience of the Great Patriotic War demonstrated the greater severity of injuries of the small intestine compared to damage to the large intestine [9], which was noted by the great N.I. Pirogov [7]. The article shows that the treatment of gunshot peritonitis [10, 11, 12] remains one of the most difficult sections, even at the high modern level of development of surgery, including military field surgery. In every second case, peritonitis acquired a progressive course, which occurred with injuries in local conflicts as well, i.e. in the Afghan and Chechen campaigns [19, 24].