277. “Eviscerated but he’ll do all right.”

Santillo, Anthony A., Pvt. 42115602 Age 29 ‘G’ Co 179th Inf Regt
Injured 1445 hrs. 10 Jan 45 Shell frag.
2nd Bn Aid Sta 179th 1530 hrs. Sulf dressing 250 cc plasma. M.S. gr 1/4
Co B Coll Sta 120th Med Bn 1700 hrs.    
120th Med Bn Clr Sta 1745 hrs.    
57th Field Hospital 1800 hrs.    

Gen’l condition on admission fair. B.P. 120/70. Approximately 3 feet of small bowel were herniating through left abdominal wound. One small perforation in loop of ileum. Abd. rigid and tender ++++. Urine clear.

Diagnosis: S.F.W. pen. and perf. abdominal wall, left and right thighs. Evisceration.

Preoperative Rx

1745 hrs. 500 cc plasma
1805 hrs. 500 cc plasma
1845 hrs. 500 cc plasma. Urine clear. Xray shows large F.B. in abdominal wall at upper end of incision.


1920 hrs. B.P. 140/70 P. 136 Endotracheal E & O2
2010 hrs. B.P. 80/40 P. 100 Operation started.
2045 hrs. B.P. 82/46 P. 104  
2100 hrs. B.P. 84/50 P. 100  
2105 hrs. B.P. 98/54 P. 104  
2130 hrs. B.P. 90/50 P. 96 500 cc blood.
2145 hrs. B.P. 120/60 P. 104 Operation ended.

Abdomen prepped and presenting bowel was cleaned with warm N. saline. One exteriorized loop was perforated. All but this loop returned to peritoneal cavity. Abd. redraped. Perf. closed. Peritoneal cavity packed off and wd. debrided. There was extensive fascia and muscle loss--internal oblique, left rectus muscles extensively damaged. Fascia of external oblique also was severely lacerated. Largest of 3 F.B.’s removed from abdominal wall at upper end of incision. Wd. was greatly contaminated by clothing and other debris. Abd. explored. Neg. except for the one perf. of ileum. 10 gms. sulf into peritoneal cavity. Retention sutures thru all layers. Abd. closed in layers with catgut as tissues would permit. Two penrose drains to wd. Retention sutures tied over rubber tubes. Perf. wd. left thigh debrided. Tract contained clothing bits. Tract irrigated with normal saline. Pen. wd right thigh debrided. F.B. removed. Pen. wd at left ant. sup. iliac spine debrided. F.B. removed. Incomplete fracture of ilium here. Condition good at end of op.

Jan 14 Wd dressed. Appears clean. T 99.
Jan 17 Wd redressed. Wds are clean. Retention suture not tight.
Jan 20 Evacuated. Condition good.
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