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Anorectal injuries in children.
1Department of Surgery, Ahmadu Bello University, Teaching Hospital, Zaria, Nigeria.
Pediatric Surgery International
|August 24, 2000
Summary
Anorectal injuries (ARI) in children are rare but can lead to severe outcomes. Early diagnosis and treatment are crucial to prevent complications and mortality in pediatric patients.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Pediatric Gastroenterology
Background:
- Anorectal injuries (ARI) are infrequent in pediatric civil practice.
- In developed nations, causes often involve sexual abuse and firearms, contrasting with experiences in tropical Africa.
Purpose of the Study:
- To review the experience of managing anorectal injuries in children in tropical Africa over a decade.
- To highlight the diagnostic challenges and treatment outcomes of pediatric ARI in this region.
Main Methods:
- A retrospective study of children aged 12 years or less managed for ARI over a 10-year period.
- Data collection included injury type, presentation time, symptoms, diagnostic methods (rectal examination, proctoscopy, laparotomy), and treatment approaches.
Main Results:
- Seven children (4 girls, 3 boys) were analyzed, with injuries from blunt (4) and penetrating (3) trauma.
- Five patients had rectal injuries (3 extraperitoneal, 2 intraperitoneal), three with associated anal injuries.
- Complications included wound infections (3), and one death from peritonitis due to a missed intraperitoneal rectal injury (IRI).
Conclusions:
- Anorectal injuries in children, though uncommon, carry significant morbidity and mortality risks.
- Meticulous rectal examination and visualization are essential to avoid missed diagnoses, particularly for intraperitoneal rectal injuries.
- Prompt and appropriate management, including surgical repair and colostomy when indicated, is vital for favorable outcomes.