After a Grueling Operation, Hope

By the time the Pope reached the Gemelli Polyclinic, he was barely conscious and bleeding heavily. A team of doctors headed by Francesco Crucitti immediately began the work of assessing the injuries. A sample of his blood was taken for quick typing (he requires not-too-common Type A, Rh-negative), and the doctors started giving him fluids intravenously. General anesthesia was administered through a tube inserted down his throat, which also facilitated breathing.

After opening the abdominal cavity with an incision of about six to eight inches, the doctors made a careful inspection to see if the twisting bullet had damaged any major blood vessels or organs. There was special concern that it might have hit the pancreas, which produces digestive enzymes that can dissolve tissue and, if they leak out, cause severe inflammation. Fortunately that vital organ escaped damage. Then the doctors ran their gloved hands along the entire 20-ft. length of the small intestine and the 5 ft. of large intestine. Typically this inch-by-inch examination is repeated two or three times to make certain no injury escapes notice. Any bleeding vessels are quickly sewed and any holes in the intestine are clamped. The first objective is to halt the loss of blood to keep the patient from slipping into shock--the most immediate danger in abdominal wounds. The other is to prevent the seepage of infection-causing bacteria into the abdominal cavity.

The entire cavity was also washed with an antiseptic solution. As one doctor bluntly put it: "He had a bellyful of blood and feces." Throughout the procedure, the emergency team monitored vital signs and administered life-sustaining fluids. The Pope was given six pints of blood, about three-fifths of the body's normal circulating volume.

Only then was it possible to turn to the actual job of repairing the extensive damage: multiple wounds in the small intestine, in the lower part of the colon (large intestine) and in the mesentery (the tissue that holds the intestine to the rear abdominal wall). The doctors apparently removed two damaged sections of the small intestine and one of the large intestine, then sewed the ends back together. The surgeons also performed a temporary colostomy, rerouting the colon through a hole they created in the abdominal wall. A colostomy allows wastes to be collected in an external bag, giving the lower end of the intestine a chance to heal. The doctors now say that in about a month the colon can be reconnected.

By the next day the Pope's pulse rose slightly, to 105 beats per minute, but his temperature remained near normal. He was in considerable pain, predictably, as the doctors explained. There is always a danger of complicating infections that sometimes develop after major abdominal injuries. To reduce that risk the doctors dosed him with antibiotics. Said Crucitti: "I do not hide that the situation is grave and the next few days will give us the answer, which we hope will be favorable." If there is no crisis, in several days the Pope will probably begin drinking liquids and eating semisolid food. Even before the colon is rejoined, he should start light exercise like walking and resume limited activities, though it may be six weeks or so before he will appear in public again. If healing is normal, as is usual in well-tended abdominal wounds without damage to major organs, there should be no serious, long-term consequences.

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