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Traumatic lesions of the rectum
International Journal of Colorectal Disease
|July 1, 1986
Summary
This study on rectal trauma management found that fecal diversion with colostomy is successful for intraperitoneal injuries and sphincter damage. Local repair without diversion is effective for most extraperitoneal rectal injuries.
Area of Science:
- Colorectal Surgery
- Trauma Management
Background:
- Rectal trauma presents diverse etiologies including sexual trauma, road accidents, and impalement.
- Management strategies for rectal trauma vary based on injury location and severity.
Purpose of the Study:
- To evaluate the outcomes of different surgical approaches for rectal trauma.
- To assess the efficacy of fecal diversion and local repair techniques.
Main Methods:
- Retrospective review of 22 patients treated for rectal trauma between 1975 and 1985.
- Analysis of treatment strategies based on injury type (intraperitoneal vs. extraperitoneal) and associated complications (peritonitis, sphincter injury).
Main Results:
- Overall treatment mortality was 9% (2 deaths).
- Defunctioning colostomy and immediate repair were used for 14 patients with peritonitis or sphincter injury.
- Successful colostomy closure in 13 of 14 patients; 7 of 8 sphincter repairs were successful.
Conclusions:
- A policy of fecal diversion is successful for intraperitoneal rectal injuries and sphincter damage.
- Local repair without diversion is effective for most extraperitoneal rectal injuries, minimizing morbidity.