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An unusual stab wound to the buttock
Ashraf F Hefny1, Elnazeer A Salim, Masoud O Bashir
1Department of Surgery, Al-Rahba Hospital, Abu Dhabi, United Arab Emirates ; CMHS, UAE University, Al Ain, United Arab Emirates.
Journal of Emergencies, Trauma, and Shock
|December 17, 2013
Summary
Gluteal stab wounds can cause severe rectal injuries despite appearing minor. Early detection and surgical intervention, like colostomy, are crucial to prevent complications such as fecal leakage and sepsis.
Area of Science:
- Trauma Surgery
- Colorectal Surgery
Background:
- Stab wounds to the buttock are infrequent in civilian surgical practice.
- Superficial gluteal wounds can mask significant visceral or vascular damage.
Observation:
- A patient presented with a gluteal stab wound initially managed conservatively.
- Two days post-injury, the patient developed fever, abdominal pain, and fecal discharge from the wound.
Findings:
- Exploratory laparotomy identified an extraperitoneal rectal perforation.
- A Hartmann's procedure was performed for the rectal injury.
Implications:
- Computed tomography (CT) scanning is advised for stable patients with buttock stab wounds.
- Diverging colostomy remains the standard for unrepaired extraperitoneal rectal injuries.
- Further research is required on non-diversion techniques for these injuries.
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