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Management of rectal trauma.

D Tuggle, P J Huber

    American Journal of Surgery
    |December 1, 1984
    PubMed
    Summary

    Major rectal trauma requires surgical diversion. While repair is not always necessary, diversion and presacral drainage are key for managing rectal injuries, leading to low mortality and acceptable morbidity.

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    Area of Science:

    • Trauma Surgery
    • Colorectal Surgery
    • Surgical Outcomes

    Background:

    • Rectal trauma is a severe injury often requiring surgical intervention.
    • A significant percentage of patients present with shock, indicating the severity of trauma.
    • Associated injuries are common in patients with rectal trauma.

    Purpose of the Study:

    • To review outcomes of major rectal trauma over a 9-year period.
    • To evaluate the necessity of rectal injury repair and the role of diversion and drainage.
    • To assess the effectiveness of diagnostic proctoscopy in rectal trauma cases.

    Main Methods:

    • Retrospective review of 47 patients with major rectal trauma requiring diversion.
    • Analysis of patient presentation, management strategies (antibiotics, repair, drainage, irrigation), and outcomes.
    • Correlation of diagnostic findings (digital rectal exam, proctoscopy) with injury severity and outcomes.

    Main Results:

    • Twenty-seven percent of patients presented in shock.
    • Ninety-five percent had positive findings on digital rectal examination or proctoscopy.
    • Rectal injury repair did not influence postoperative morbidity or length of hospital stay.
    • Ninety-five percent of patients underwent presacral drainage.
    • No deaths occurred, and morbidity was acceptable with diversion and drainage.

    Conclusions:

    • Proctoscopy is essential for evaluating rectal proximity wounds.
    • Diversion and presacral drainage are crucial for managing rectal injuries, associated with low mortality.
    • Rectal washout is not essential in civilian rectal trauma cases.

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