Barkesdale relates the history of the case of a Confederate
soldier who was shot at Fredericksburg in the median line of the
body, 1 1/2 inches above the symphysis, the wound of exit being
in the median line at the back, 1/2 inch lower down. Urine
escaped from both wounds and through the urethra. There were no
bad symptoms, and the wounds healed in four weeks.
The bladder is not always injured by penetration of the abdominal
wall, but may be wounded by penetration through the anus or
vagina, or even by an instrument entering the buttocks and
passing through the smaller sacrosciatic notch. Camper records
the case of a sailor who fell from a mast and struck upon some
fragments of wood, one of which entered the anus and penetrated
the bladder, the result being a rectovesical fistula. About a
year later the man consulted Camper, who unsuccessfully attempted
to extract the piece of wood; but by incising the fistula it was
found that two calculi had formed about the wooden pieces, and
when these were extracted the patient recovered. Perrin gives the
history of a man of forty who, while adjusting curtains, fell and
struck an overturned chair; one of the chair-legs penetrated the
anus. Its extraction was followed by a gush of urine, and for
several days the man suffered from incontinence of urine and
feces.
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