|Levitt, Jack, Pvt.||33814738||Age 18||Anti Tank Co 253rd Regt.|
|Injured||1600 hrs.||17 Mar ‘45||H.E.S.F. (88)|
|Tagged at Aid Sta||? hrs.||17 Mar ‘45||No Rx|
|Clr Co D 363rd Med Bn||1715 hrs.||M.S. gr 1/4 1 cc T.T.
500 cc blood
|10th Field Hosp.||1800 hrs.||17 Mar ‘45|
Gen’l condition on admission fair. B.P. 110/60. Abd. rigid and tender ++++. Small bowel herniating from left lower inguinal wd. Multiple large perf. and pen. wds. of back left and right side.
Diagnosis: S.F.W. multiple pen. and perf. lumbar region right and left severe with evisceration.
|1800 hrs.||Penicillin 20,000 units|
|1805 hrs.||B.P. 110/60||P. --|
|1825 hrs.||B.P. 120/60||Blood 500 cc.|
|1900 hrs.||B.P. 110/45|
|1930 hrs.||B.P. 100/50||P.--||gr 1/100 Atropine. Urine gross blood.|
|1950 hrs.||B.P. 130/80||P. 136||Endotracheal E & O2|
|2025 hrs.||B.P. 96/42||P. 120||Operation--debridement of back|
|2040 hrs.||B.P. 86/40||P. 120||Plasma 500 cc|
|2100 hrs.||B.P. 90/50||P. 108|
|2115 hrs.||B.P. 60/20||P. 104||Abdomen opened. Plasma 500 cc|
|2145 hrs.||B.P. 80/40||P. 108||500 cc blood|
|2220 hrs.||B.P. 80/40||P. 104||Blood 1000 cc|
|2300 hrs.||B.P. 90/50||P. 132||End of operation.|
Pt. turned on right side. Three large wds. of left lumbar region debrided. These were actually one wd beneath the skin and the skin pen were thusly joined. There was extensive muscular damage and a considerable portion of the erector spiny mass was debrided. The lower 1/3 of the left kidney had been amputated--bleeding not marked. Ureter intact. The descending colon was exposed in this large wd--it appeared to be dark and viability was questioned. A perf. wd just inf and lateral to the three joined wds was debrided. This had its exit at the anterior superior iliac spine--the ilium was incompletely fractured. Two penetrating wds. of the rt. lumbar region at L1 & L2 debrided. One tract followed down to transverse process of L1 entering retroperitoneal tissue just above L1. Penrose drain inserted. Dry gauze sulfa dressing to all these wds. The largest of the wds. had previously been closed by two chromic mattress sutures to make a support for the abdominal contents. Two penrose drains were inserted here. Pt. turned on back. Small loop of bowel prepared and dropped back into peritoneal cavity. Laporotomy thru mid left rectus incision. Blood, small bowel contents, and fecal material grossly contaminating peritoneal cavity. Two complete transections and two perforations of jejunum. Resect two feet small bowel--end to end anastomoses. There was a perf. of the splenic flexure on the distal side--this was extensive--one of the wds. including the mesenteric border. There was a lacerating perforation of the descending colon at the sigmoid which completely transected the bowel; the descending colon above this point was detached from its mesentery and was non-viable. Splenic flexure and descending colon were resected and T. colon and sigmoid were further mobilized to be brought out later as a spur colostomy. Right upper quadrant inspected--Duodenal contents were seen to leak from a perforation of the duodenum. Rectus incision extended upward. Hepatic flexure turned medially and duodenum further mobilized. Two perforations of duodenum closed. Chromic & silk interrupted. Retroperitoneal entrance of muscle seen at rt. side of vena cava (close!). This region was drained thru a right subcostal stab wd. Because of the close proximity of the spur colostomy to large wds. of the left flank and inguinal region, a loop colostomy was brought out the right subcostal region. Attempt made to reperitonealize the left gutter and iliac region. Peritoneum at wd. of exit in left lower quadrant closed. 10 gms. sulfa into peritoneal cavity. Abdomen closed in layers. Wire retention sutures to posterior rectus sheath. Penrose drain to wd. Wds. of left inguinal region debrided. Large F.B. 3x3x2 cms. removed from one of the wds. Sulfa & dry mesh gauze dressing.
|Mar 19||500 cc blood. Urine output past 24 hrs. 1925 cc. Postop condition has been surprisingly good considering the extent of the injury. Getting 2000 cc 5% glucose in saline with 5 gms. sulfa & 1000 cc plasma daily. Vit. C 1000 mg daily. Vit B.|
|Mar 20||Wds. dressed. Wds. remarkably clean. Abd. soft and flat--no tenderness. Colostomy (loop) opened. Faint suggestion of scleral icterus. 1000 cc plasma.|
|Mar 21||500 cc blood. Definite scleral icterus. T. 99. P. 108-96-R 22. Gen'l condition is good (one for Brown!). Several other pts. (4) have scleral icterus--believe it due to transfusions.|
|Mar 23||Colostomy putting out feces. IV's stopped. Clear liquids. 1000 cc plasma. Sulfa stopped.|
|Mar 24||Dressed all wds. Posterior wds. clean but draining considerably. Left colostomy opened. 500 cc blood. Getting 1000 cc plasma daily.|
|Mar 25||Evacuated today. Last three days he has been running more fever. 102 this a.m.|
AMERICAN RED CROSS
April 19, 1945
Don’t know exactly how to start this letter but in case you don’t know who this is I’m the fellow who had all that shrapnel in the back and you put those two colostomies in the front.
After I left your hospital I went to an Evac. for one day and then I came to this hospital. A Major Smith has been taking care of me and working on me. They have closed my wounds and taken the stitches out already. I’m getting along fine and get up in the wheel chair for a couple of hours a day. By the time this letter reaches you I’ll be on my way back to the states. Yes, “Doc”, I leave here in a few days and I go on a train ride to where I catch a plane. Going to “Pa.” in style in a plane.
I’ll write to you often “Doc”--as I consider you the man that saved my life, and when this thing is over I’ll come up to Scranton to pay you a visit.
Well--this is all for now as I can’t think of anything else to write about. Oh yes, “Doc” tell the blonde nurse from Mississippi that we get a Px. ration twice a week here and in each ration we get a coke!
Regards to all the nurses.