JAMA. 1944;124(8):491-497. doi:10.1001/jama.1944.02850080019006.
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The operative treatment of penetrating wounds of the abdomen has changed but little in the past twenty years. Lower mortality has been attained chiefly by the introduction of improvements in anesthesia, by the more liberal use of blood and plasma transfusions, by the postoperative use of continuous gastric suction and by the use of the sulfonamide drugs. A patient presenting himself with a penetrating wound of the abdomen should be examined quickly but thoroughly to see, first, if he is in shock, second, the nature and extent of the external wound and evidence as to the direction of the stab or gunshot wound, and, third, for signs of peritoneal irritation. Local exploration of the wound, except under anesthesia, is usually not a wise policy, for it may spread infection to probe it and may lead to erroneous conclusions as to whether it penetrates the peritoneal cavity. In cases of doubt,


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