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Case Reports
- Management of a traumatic anorectal full-thickness laceration: a case report
- Laura Fortuna, Andrea Bottari, Riccardo Somigli, Sandro Giannessi
- J Trauma Inj. 2022;35(3):215-218. Published online May 19, 2022
- DOI: https://doi.org/10.20408/jti.2021.0049
- 2,446 View
- 125 Download
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Abstract
PDF - The rectum is the least frequently injured organ in trauma, with an incidence of about 1% to 3% in trauma cases involving civilians. Most rectal injuries are caused by gunshot wounds, blunt force trauma, and stab wounds. A 46-year-old male patient was crushed between two vehicles while he was working. He was hemodynamically unstable, and the Focused Assessment with Sonography for Trauma showed hemoperitoneum and hemoretroperitoneum; therefore, damage control surgery with pelvic packing was performed. A subsequent whole-body computed tomography scan showed a displaced pelvic bone and sacrum fracture. There was evidence of an anorectal full-thickness laceration and urethral laceration. In second-look surgery performed 48 hours later, the pelvis was stabilized with external fixators, and it was decided to proceed with loop sigmoid colostomy. A tractioned rectal probe with an internal balloon was positioned in order to approach the flaps of the rectal wall laceration. On postoperative day 13, a radiological examination with endoluminal contrast injected from the stoma after removal of the balloon was performed and showed no evidence of extraluminal leak. Rectosigmoidoscopy, rectal manometry, anal sphincter electromyography, and trans-stomic transit examinations showed normal findings, indicating that it was appropriate to proceed with the closure of the colostomy. The postoperative course was uneventful. The optimal management for extraperitoneal penetrating rectal injuries continues to evolve. Primary repair with fecal diversion is the mainstay of treatment, and a conservative approach to rectal lacerations with an internal balloon in a rectal probe could provide a possibility for healing with a lower risk of complications.
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Summary
- Diagnostic Laparoscopy and Laparoscopic Diverting Sigmoid Loop Colostomy in Penetrating Extraperitoneal Rectal Injury: A Case Report
- Young Goun Jo, Yun Chul Park, Wu Seong Kang, Jung Chul Kim, Chan Yong Park
- J Trauma Inj. 2017;30(4):216-219. Published online December 30, 2017
- DOI: https://doi.org/10.20408/jti.2017.30.4.216
- 5,519 View
- 26 Download
- 1 Citations
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Abstract
PDF
Laparoscopy has been one of the most effective modalities in various surgical situations, although its use in trauma patients has some limitations. The benefits of laparoscopy include cost-effectiveness, shorter length of hospital stay, and less postoperative pain. This report describes diagnostic laparoscopy and laparoscopic diverting sigmoid loop colostomy in penetrating extraperitoneal rectal injury. A 41-year-old male presented with perineal pain following penetrating trauma caused by a tree limb. Computed tomography showed air density in the perirectal space and retroperitoneum. As his vital signs were stable, we performed diagnostic laparoscopy and confirmed no intraperitoneal perforation. Therefore, laparoscopic diverting sigmoid loop colostomy was performed. He was discharged without any complications despite underlying hepatitis C-related cirrhosis. Colostomy closure was performed 3 months later.
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Summary
Citations
Citations to this article as recorded by
- The floating rectum
Sean Ng Kwet Chi Ng Ying Kin, William Jiang, Asiri Arachchi, Hanumant Chouhan
ANZ Journal of Surgery.2022; 92(1-2): 264. CrossRef
- Colorectal Foreign Bodies: Six Cases Report and Review of the Literature
- Hyoungran Kim, Seokho Choi, Jeongseok Yun
- J Trauma Inj. 2015;28(1):51-54. Published online March 30, 2015
- DOI: https://doi.org/10.20408/jti.2015.28.1.51
- 2,003 View
- 6 Download
- 1 Citations
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Abstract
PDF
- The incidence of foreign body insertion in the anorectum is rare, however, it is increasing, especially in urban populations. Foreign objects in the anorectum can be of different sizes, shapes and materials. Frangible objects like glass or beakers, and sharp foreign bodies that may easily injure the bowel mucosa are particularly dangerous. Physicians have to consider more innovative options on how to extract these foreign bodies without inciting injury; and, if injury would occur, consider different techniques to repair it, whether transanally or transabdominally, and opt for primary repair, or resection with either anastomosis or stoma creation. Here, I introduce our cases with colorectal foreign bodies and present several literatures to help physicians decide when presented with cases like these.
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Summary
Citations
Citations to this article as recorded by- Bike handlebar grip in the rectum: minimally invasive endoscopic management
Danilo Paduano, Francesco Auriemma, Mario Bianchetti, Alessandro Repici, Benedetto Mangiavillano
Endoscopy.2022; 54(02): E42. CrossRef
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