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Published on: November 9, 2016
[Traumatic injuries of the rectum and anus in childhood]
1Pavlov Ryazan State Medical University, Ryazan, Russia.
Insights
Traumatic anorectal injuries in children are severe, often resulting from combined trauma. Prompt diagnosis and surgical intervention are crucial for favorable outcomes in these pediatric cases.
Area of Science:
- Pediatric Surgery
- Trauma Surgery
- Pediatric Urology
Context:
- Anorectal injuries represent severe pediatric trauma.
- These injuries often occur as part of combined trauma, necessitating comprehensive management.
- The study analyzes a cohort of 31 children aged 1-18 years with traumatic anorectal injuries.
Purpose:
- To analyze treatment outcomes in children with traumatic anorectal injuries.
- To highlight the diverse etiologies of pediatric anorectal trauma, including accidents, foreign bodies, and iatrogenic causes.
- To emphasize the critical role of timely diagnosis and emergency care in managing life-threatening syndromes associated with these injuries.
Summary:
- Thirty-one pediatric patients with anorectal injuries were evaluated using anamnesis, physical examination, rectal examination, bladder catheterization, and advanced imaging (CT, MRI).
- Etiologies included traffic accidents (9), foreign bodies (10), thermal trauma (3), sexual abuse (2), and post-surgical complications (6).
- Surgical treatment yielded favorable outcomes in all evaluated pediatric cases.
Impact:
- This study underscores the severity of traumatic anorectal injuries in children.
- It highlights the importance of a multidisciplinary approach for diagnosis and treatment.
- Favorable surgical outcomes suggest effective management strategies for pediatric anorectal trauma.
Objective:
To analyze treatment outcomes in children with anorectal injury.
Material And Methods:
There were 31 children aged 1-18 years with traumatic injuries of the rectum and anus. Diagnostic measures included analysis of anamnesis, examination, rectal examination, bladder catheterization, X-ray methods including CT and MRI.
Results:
Over the past 30 years, combined trauma has occurred in 346 children. Of these, 217 children died at the scene, 12 - in hospitals. Injuries of more than 3 areas were observed in 184 children. Injuries of the rectum and anus were diagnosed in 31 children. In 9 children, anorectal injury was the result of traffic accidents. All ones had TBI, thoracoabdominal trauma, bone fractures of extremities and pelvis. Four people died at the scene. In 10 children, anorectal injury was associated with damage by foreign bodies including falling from height (n=2) and sledding (n=2). In one child, damage to the rectum and large intestine was associated with injection of compressed air into the rectum under pressure. Thermal trauma of the perineum with anorectal injury occurred in 3 young children. Two girls younger 6 years old had anorectal injury due to rape. In 6 children, damage to the rectum occurred after pelvic surgery (n=4) and injury of sphincter in patients with rectal atresia (n=2). The author presents 3 own cases.
Conclusion:
Traumatic anorectal injuries are severe lesions in childhood. The primary objective in patients with combined trauma and anorectal injury is to save the child's life through diagnosis and treatment of life-threatening syndromes. Diagnosis and treatment should be carried out after exclusion of all probable causes taking into account the need for emergency care. Surgical treatment was favorable in all children.
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