267. Drunk on Duty in the Shock Ward

Case, Ira L., Pvt. 42021580 Age 20 19 Armored Inf Bn.
Injured 1030 hrs. 31 Dec 44 H.E.S.F.
94th Cav. Recn Sq Bn Aid 1030 hrs.   M.S. gr 1/4
14th A.D. Clr Sta     no treatment
57th Field Hospital 1430 hrs.    

Gen’l condition on admission good. (Shock records poor--James was drunk on duty). B.P. supposedly normal. Abd. tender and rigid ++. Urine clear.

Diagnosis: S.F.W. pen. left lumbar region, sv.

Preop Rx: 1000 cc plasma and M.S. Blood pressures and times not recorded. Amt. of M.S. not recorded.


1900 hrs. B.P. 120/70 P. 154 N.S. & G. 1000 cc. Endotracheal A. E & O2
1930 hrs. B.P. 110/70 P. 154 Operation (pt. on rt side)
1945 hrs. B.P. 80/40 P. 152 Laporotomy. Blood 500 cc
2000 hrs. B.P. 90/50 P. 154  
2015 hrs. B.P. 100/60    
2045 hrs. B.P. 104/60 P. 140  
2100 hrs. B.P. 110/60 P. 140 Operation ended

Pt. turned on right side--pen. wd of left lumbar region just below 12th rib debrided. Kidney felt. No penetration. Penrose drain inserted. Pt. turned on back with lift beneath left flank and infra costal region. Left rectus incision. Extensive extravasation of blood subserosal over upper ½ descending colon. No perforation found on peritoneum covered surface. Small bowel negative. Spleen neg. Splenic flexure and upper ½ of descending colon mobilized. Two perforations found each 1 cm in diameter and 3 cms apart at mesenteric border. F.B. felt in retroperitoneal tissues deep to second and more medial perforation. Pen. wd of lumbar region at this site. Drain which previously had been inserted was pulled further into abdomen and laid to site of retroperitoneal insult. Spur colostomy formed and delivered thru left subcostal stab wd. 10 gms sulf into belly. Retention sutures thru all layers. Abdomen closed in layers. Condition good at end of operation.

Pt. evacuated under anesthesia because we had to get out fast.


February 2

Dear Captain Kinnedy,

I guess you though you weren’t ever going to here from me. I am just getting so I can do such things as write letters. After I went to the General Hospital they kept me on decompression for twelve days. Then I began eating until Jan 22. That is when they moved me again and it upset me so I couldn’t hold any food down for eight more days. Believe me I had dreams every night about, and it made the most interesting conversation. I am eating a regular tray now and for the first time this week I have able to sleep the night through. I feel better to.

I just have to put on some weight now and get that incision healed up, as I look like “meatless Tuesday now.”

Well sir it was very nice of you to show so much interest in me. Are you interested in all of your patients like you are in me.

The staff of the last hospital was made up from Buffalo General Hospital. The Doc there turned out to be practically my neighbor.

I’ll close now, wishing you good luck and more successful operations. I believe I have had the best of care right from the start.

Pvt. Ira L. Case

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