Pulls guts out (4)
I believe the answer is:
tugs
'pulls' is the definition.
(tugging is a kind of pulling)
'guts out' is the wordplay.
'out' indicates anagramming the letters (out can mean wrong or inaccurate).
'guts' anagrammed gives 'TUGS'.
(Other definitions for tugs that I've seen before include "Pulls hard" , "Pulls in a jerking manner" , "Tows" , "Yanks" .)