EVISCERATION

Evisceration, also known as disembowelment, is any form of injury that ends with your character’s insides on the outside, with their guts hanging out. Their bowels are literally in their lap.

The abdomen is essentially a madhouse of overpacking. The intestine, or small bowel, is approximately 25 feet of tightly bunched material that is held in place by a thick membrane called the peritoneum, which lines the abdominal cavity and is folded over those densely packed organs. When the peritoneum is ruptured, the guts come out.

The interesting thing about this injury is that the intestines themselves don’t even need to rupture for this to be an absolutely devastating and likely-to-be-deadly injury. Even if the bowels are miraculously intact, the odds of getting an infection are extremely high, and your target's life is on the line.

Meanwhile, they have a problem: they have guts in their hands and they can’t get them back in!

The target will be left vulnerable to additional injury, though an attack that leaves its victim extruding sausage into the open is likely to make the attacker think the job has been done. Either way, this target is instantly out of the fight, even if they retain strength; the horror of the injury is enough to disable them as a fighter.

In reality, in the majority of cases in which any part of the abdominal contents is welcomed to the outside world, what comes out is not actually an organ, but the omentum, a great protective apron of tough, fibrous tissue and fat that protects the underlying organs. However, the target's with these injuries are still in deep trouble: 8 in 10 wounds with an evisceration will include another internal injury that requires surgical repair.

Lethality

While some forms of evisceration are inherently lethal, including those with massive hemorrhage because if you go deep enough you can lacerate the aorta or where the entire abdominal contents are extruded and mangled or destroyed.

In the former case, exsanguination (heavy blood loss) is the primary concern. In the latter, the real worry is infection.

This type of injury will deliver also a lot of pain.

How Does It Happen?

In order for matter to exit the abdominal cavity, it needs…

…a clear exit pathway. This typically involves a thrusting movement with the blade that will penetrate deep enough and then a slashing movement in the lateral opening the belly out.

We find the evisceration or disembowelment also at the samurai warrior clans in their ritualistic suicide call Seppuku or Hara-kiri.

The most common form of seppuku for men was composed of the cutting of the abdomen, and when the samurai was finished, he stretched out his neck for an assistant to sever his spinal cord. It was the assistant's job to decapitate the samurai in one swing, otherwise it would bring great shame to the assistant and his family. Those who did not belong to the samurai caste were never ordered or expected to carry out seppuku. Samurai generally could carry out the act only with permission.