Traumatic lesions of the rectum

Twenty-two patients treated for rectal trauma between 1975 and 1985 were reviewed. There were 13 males and nine females, of mean age 38 years (18-72 years). Causes included gunshot (2), sexual trauma (8), road accident (5), impalement (5), polypectomy (2). Two patients died, giving a treatment mortality of 9%. Cases with peritonitis or sphincter injury were treated by defunctioning colostomy and immediate repair of rectum and sphincter. Of 14 such patients the colostomy had been closed in all but one, who accounted for the only failed sphincter repair out of eight performed. The results show the success of a policy of faecal diversion for intraperitoneal rectal injury and sphincter damage and of local repair without diversion for most cases with extraperitoneal rectal injury.