Surgery of the Abdomen, Exclusive of Hernia [excerpt]

     The empty stomach is simply perforated by the modern bullet, the wound of exit being slightly larger than the wound of entrance, while a full stomach struck by a bullet is burst apart.
     In searching for the wound of exit through an incision in the anterior gastric wall, Cumston emphasizes the necessity of making the wound large enough to afford a clear view. To show the disadvantages of a small opening, he cites the case of the late President McKinley in which digital examination through a small incision in the anterior wall of the stomach failed to find the perforation in the posterior wall. It must not be forgotten that the wound of exit may be in the posterior wall of the duodenum.