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Rectal necrosis after pelvic crush injury
R G Tompkins1, C J McCabe, J F Burke
1Department of Surgery, Massachusetts General Hospital, Boston 02114.
The Journal of Trauma
|May 1, 1988
Summary
Severe pelvic crush injuries can cause rectal transmural necrosis due to blocked arteries and disrupted blood flow. This case highlights the critical vascular complications following major pelvic trauma.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Colorectal Surgery
Background:
- Pelvic crush injuries represent a significant challenge in trauma care, often associated with severe hemorrhage and multi-organ damage.
- Understanding the vascular anatomy and potential compromise following pelvic trauma is crucial for timely intervention.
Observation:
- A case report details a patient experiencing transmural necrosis of the rectum.
- This complication arose subsequent to a severe pelvic crush injury in an obese male patient.
Findings:
- The rectal necrosis is presumed to stem from the occlusion of both internal iliac arteries.
- Disruption of the pelvic collateral circulation further contributed to the ischemic event.
- Direct rectal contusion also played a role in the observed pathological changes.
Implications:
- This case underscores the potential for severe ischemic complications in the rectum following pelvic crush injuries.
- Highlights the importance of assessing and managing vascular compromise in the pelvic region after major trauma.
- Suggests a need for vigilance regarding rectal viability in patients with extensive pelvic injuries, particularly those with contributing factors like obesity.