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Updated: May 14, 2025
In addition there was an abdominal wound 6 1/2 inches long, extending from the navel to about two inches above Poupart's ligament, causing almost complete intestinal evisceration. The lung was partially collapsed. The cartilages were ligated with heavy silk, and the hemorrhage checked by ligature and by packing gauze in the inter-chondral spaces.
Aneurysms of the vessels of the #forearm and hand# call for no special mention; they are almost invariably traumatic, and are treated by excision of the sac. Aneurysms appearing in the region of Poupart's ligament may have their origin in the external or common iliac arteries or in the upper part of the femoral.
On account of the tension of the fascia lata, they tend to spread upwards towards the abdomen, and, to a less extent, downwards into the thigh. Sometimes a constriction occurs across the sac at the level of Poupart's ligament. The pressure exerted on the nerves and veins of the lower extremity causes pain, congestion, and œdema of the limb.
Several of the glands along Poupart's ligament, on one or on both sides, become enlarged, rounded, and indurated; they are usually freely movable, and are rarely sensitive unless there is superadded septic infection. The term bullet-bubo has been applied to them, and their presence is of great value in diagnosis.
The stake entered just in front of the right spermatic cord, passed beneath Poupart's ligament into the cavity of the abdomen, traversed the whole cavity across to the left side; it then entered the thorax by perforating the diaphragm, displaced the heart by pushing it to the right of the sternum, and pierced the left lung.
In quadrupeds the main weight of the abdominal viscera is supported by the ribs and by strong pectoral and abdominal muscles. The weakest part of the latter group of muscles is in the region of Poupart's ligament, above the groin. Inguinal hernia is rare in other vertebrates because this weak part is relieved by the pressure of the viscera.
Sometimes it is hour-glass or dumb-bell shaped, as is well illustrated in the region of the groin in disease of the spine or pelvis, where there may be a large sac occupying the venter ilii, and a smaller one in the thigh, the two communicating by a narrow channel under Poupart's ligament. By pressing with the fingers the pus may be displaced from one compartment to the other.
The ball entered on the left side of the abdomen, its lower edge grazing the center of Poupart's ligament, and passing backward, inward, and slightly upward, emerged one inch to the left of the spinous process of the sacrum. On July 6th all the symptoms of peritonitis made their appearance. On July 11th there was free discharge of fecal matter from both anterior and posterior wounds.
"Very good, Monsieur le comte," said Antonin, returning them. "Make a list of all the votes on which the ministry may count. Above all, let no one suspect that you and I understand each other. I am a speculator in land, and I don't care a fig for elections." "I will send the commissary of police to force you to inscribe your name on Poupart's register." "So do. Adieu, monsieur.
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