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Published on: November 9, 2016

Outcomes and management of rectal injuries in children

Arnaud Bonnard1, Mohammed Zamakhshary, Paul W Wales

  • 1Division of General Surgery, Hospital for Sick Children, Room 1526, 555 University Avenue, Toronto, ON, Canada M5G 1X8.

Pediatric Surgery International
|August 22, 2007
PubMed

Insights

Pediatric rectal injuries, often from vehicle collisions, can sometimes be treated with primary repair without fecal diversion. Laparoscopy aids in diagnosing and managing complex penetrating trauma in children.

Area of Science:

  • Pediatric Surgery
  • Trauma Surgery
  • Colorectal Surgery

Background:

  • Rectal injuries in children are typically caused by motor vehicle collisions.
  • There is growing interest in selective rectal injury management and laparoscopic techniques in adults.

Purpose of the Study:

  • To review institutional experience with pediatric rectal injuries.
  • To identify a subset of patients amenable to selective diversion or primary repair.

Main Methods:

  • Retrospective review of pediatric rectal injury cases over 20 years (1984-2004).
  • Data abstraction included demographics, injury details, diagnosis, treatment, and complications.
  • Laparoscopy was utilized in two penetrating injury cases.

Main Results:

  • Nine pediatric patients with rectal injuries were identified (average ISS 19.3).
  • Primary repair without diverting colostomy was successful in 3 patients (2 intraperitoneal, 1 extraperitoneal).
  • Laparoscopy helped define injury extent and guide colostomy in penetrating trauma.

Conclusions:

  • Primary repair without fecal diversion may be safe in select pediatric patients.
  • Laparoscopy can be valuable for diagnosing and managing penetrating rectal trauma in children.
  • Further research is needed due to the limited sample size.

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