What is evisceration?
A.
Bursting open of the wound
B.
Wound edges not approximating
C.
Opening of the wound
D.
The viscera spilling out of the abdomen
The Correct Answer and Explanation is:
Correct Answer: D. The viscera spilling out of the abdomen
Explanation:
Evisceration is a serious and often life-threatening surgical complication that involves the protrusion of internal organs, particularly the abdominal viscera (such as intestines), through a wound or surgical incision. This condition occurs when there is a complete rupture of all layers of the wound, leading to the exposure and spilling out of internal organs. It is most commonly associated with abdominal surgeries but can occur with any type of incision that fails to heal properly.
Understanding Evisceration:
- Mechanism of Occurrence: Evisceration usually results from a failure of the surgical wound to heal appropriately. Factors such as infection, increased intra-abdominal pressure (due to coughing, vomiting, or straining), poor nutritional status, obesity, or improper suturing techniques can increase the risk of evisceration. The condition may occur suddenly, often preceded by dehiscence, where the wound edges start to separate.
- Clinical Presentation: Patients experiencing evisceration may report a sudden sensation of “popping” or “giving way” at the wound site, followed by the appearance of internal organs outside the body. This is a surgical emergency and requires immediate medical attention.
- Complications: Evisceration can lead to severe complications, including infection, peritonitis (inflammation of the peritoneum), shock, and even death if not treated promptly. The exposed organs are at high risk for contamination, which can exacerbate the situation.
- Immediate Management: The priority in managing evisceration is to cover the exposed viscera with sterile, saline-soaked dressings to protect them from contamination and dehydration. The patient should be kept calm and in a position that minimizes tension on the wound, typically lying flat with knees bent. Immediate surgical intervention is required to return the organs to the abdominal cavity and close the wound properly.
- Prevention: Preventive measures include ensuring proper wound care, monitoring for signs of infection, and advising patients on activities that might increase intra-abdominal pressure post-surgery. Healthcare providers should educate patients on the importance of reporting any unusual sensations or changes in the wound immediately.
In summary, evisceration is a critical condition that necessitates prompt surgical intervention to prevent life-threatening complications. The correct answer, D, accurately describes this dangerous scenario where the viscera spill out of the abdomen due to wound failure.