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Related Experiment Videos

Civilian rectal trauma: a changing perspective.

J J Morken1, J J Kraatz, E G Balcos

  • 1Department of Surgery, Hennepin County Medical Center, Minneapolis, Minn 55415, USA.

Surgery
|October 16, 1999
PubMed
Summary

The Rectal Injury Scaling System (RISS) may guide treatment for rectal trauma. Aggressive surgery for RISS grade I injuries might be unnecessary, potentially improving patient outcomes.

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Area of Science:

  • Trauma Surgery
  • Colorectal Surgery
  • Surgical Outcomes

Background:

  • The American Association for the Surgery of Trauma developed the Rectal Injury Scaling System (RISS).
  • Limited data exist on the clinical utility of the RISS.

Purpose of the Study:

  • To evaluate the clinical utility of the RISS in managing rectal injuries.
  • To assess the impact of RISS grading on patient management and outcomes.

Main Methods:

  • Retrospective review of 45 patients with rectal injuries.
  • Comparison of RISS grade I (partial-thickness) injuries with grades 2-4 (full-thickness) injuries.

Main Results:

  • Full-thickness injuries (grades 2-4) underwent more frequent rectal washout and diversion.

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  • Full-thickness injuries had a significantly higher complication rate (3-fold increase).
  • Complications in partial-thickness injuries (grade I) occurred only with aggressive management (washout/diversion).

    • Conclusions:

    • Aggressive surgical management may not be indicated for RISS grade I rectal injuries.
    • RISS-guided therapy has the potential to improve outcomes in civilian rectal trauma.