Society of Physicians at Kazan University. Surgical section. Meeting 14/1-29

Dr. M. S. Znamensky. A case of removing a bullet from the left lung of a serviceman who was accidentally (blind) wounded from a machine gun during shooting practice at a distance of about a kilometer. Entrance hole on the anterior axillary line on the left. After the injury - severe shortness of breath, there was no hemoptysis, constant pain in the left side, deep breaths are especially painful. Fluoroscopy: a bullet not deformed in the left half of the chest, pointed outwards. When inhaled, it shifts downward. When viewed from the front, the bullet is vaguely contoured and appears larger than its normal size; from the rear it is clearly contoured and of normal size. Its level is the VIII rib at the back. The bullet was extracted under the direct control of X-rays through an incision in the back, along the 8th rib with partial excision of the last and adjacent 9th. Before opening the pleura, there are three sutures fixing the lungs. When the pleura was opened, the lung was grasped with fenestrated forceps and removed from the wound. The bullet was found in the extracted part of the lung at a depth of ½ sant, under the visceral pleura in the granulating cavity. The lung wound was sutured with catgut sutures and fixed to the pleural wound. Iodoform graduate. Stitches for muscles and skin. The postoperative course is smooth and by the time of the demonstration (after about a month after the operation) the patient feels quite satisfactory. The X-ray tube was placed under the table, the screen, wrapped in a pillowcase with a cut out window, was superimposed on top. Lighting - for specific moments of the operation. Debate: Prof. P. M. Krasin, M. O. Friedland and V. L. Bogolyubov and pre-doc. VA Gusynin, who attributed the success of the operation to the skillful use — in Kazan conditions for the first time — of X-rays as a controller of the course of the operation.