Unusual perforating wound of the abdomen and thorax.

Abstract

IT IS BELIEVED that the following case of abdominothoracic stab wound is sufficiently unusual to warrant reporting. REPORT OF CASE A 25-yr.-old Puerto Rican veteran of World War II was admitted to Tripler Army Hospital approximately three hours after he was injured in an automobile wreck. He was in severe pain but was not in shock. The blood pressure was 118/72, pulse rate 94 and respiratory rate 24. He was vomiting coffee-ground material. The abdomen was boardlike in its rigidity. No peristaltic sounds were audible. The skin of the left lower anterior chest wall was tented upward about 2 in. (5 cm.) in the midclavicular line. The left costal margin could not be palpated satisfactorily because of pain and marked rigidity of the abdominal wall. Crepitus was palpated in the subcutaneous tissue about the deformity of the chest wall and was interpreted as subcutaneous emphysema. When the patient was rotated