Outcomes of Civilian Penetrating Rectal Injuries Associated With Genitourinary and Bony Injuries

Area of Science:

• Trauma Surgery
• Surgical Outcomes
• Injury Management

Background:

• Combined rectal, bladder, and bone injuries are rare but severe.
• These injuries present significant challenges in trauma care.
• Evaluating outcomes of these complex injuries is crucial.

Purpose of the Study:

• To assess the outcomes of patients with combined rectal, bladder, and bone injuries.
• To determine the safety and efficacy of current management strategies.
• To identify factors influencing morbidity and mortality.

Main Methods:

• Retrospective review of 104 patients with penetrating rectal injuries (2010-2019).
• Analysis of management for intraperitoneal vs. extraperitoneal rectal and bladder injuries.
• Documentation of infectious complications and mortality.

Main Results:

• 42% had genitourinary injuries; 48% had bone fractures (sacral, iliac, pelvic).
• 91 diverting loop colostomies performed; 9 fistulae observed (6.7%).
• 27 infectious complications noted, including surgical site and soft tissue infections.

Conclusions:

• Extraperitoneal rectal injuries with bladder/bone trauma can be managed safely.
• Fecal diversion and cystostomy are effective strategies.
• Minimal morbidity achieved with appropriate surgical interventions.