Civilian extraperitoneal rectal gunshot injuries: Surgical management made simpler

 

Show simple item record

dc.contributor.author Navsaria, Pradeep H
dc.contributor.author Edu, Sorin
dc.contributor.author Nicol, Andrew J
dc.date.accessioned 2017-05-17T08:37:37Z
dc.date.available 2017-05-17T08:37:37Z
dc.date.issued 2007
dc.identifier http://dx.doi.org/10.1007/s00268-007-9045-z
dc.identifier.citation Navsaria, P. H., Edu, S., & Nicol, A. J. (2007). Civilian extraperitoneal rectal gunshot wounds: surgical management made simpler. World journal of surgery, 31(6), 1347-1353.
dc.identifier.uri http://hdl.handle.net/11427/24339
dc.description.abstract Background: Rectal injuries are associated with significant morbidity and mortality. Controversy persists regarding routine presacral drainage, distal rectal washout (DRW), and primary repair of extraperitoneal rectal injuries. This retrospective review was performed to determine the outcome of rectal injuries in an urban trauma center with a high incidence of penetrating trauma where a non-aggressive surgical approach to these injuries is practiced. Methods: The records of all patients with a full-thickness penetrating rectal injury admitted to the Trauma Center at Groote Schuur Hospital over a 4-year period were reviewed. These were reviewed for demographics, injury mechanism and perioperative management, anatomical site of the rectal injury, associated intra-abdominal injuries and their management. Infectious complications and mortality were noted. Intraperitoneal rectal injuries were primarily repaired, with or without fecal diversion. Extraperitoneal rectal injuries were generally left untouched and a diverting colostomy was done. Presacral drainage and DRW were not routinely performed. Results: Ninety-two patients with 118 rectal injuries [intraperitoneal (7), extraperitoneal (59), combined (26)] were identified. Only two extraperitoneal rectal injuries were repaired. None had presacral drainage. Eighty-six sigmoid loop colostomies were done. Two (2.2%) fistula, one rectocutaneous, and one rectovesical, were recorded. There were nine (9.9%) infectious complications: surgical site infection (4), buttock abscess (1), buttock necrosis (1), pubic ramus osteitis (1), septic arthritis (2). No perirectal sepsis occurred. Conclusions Extraperitoneal rectal injuries due to low-velocity trauma can be safely managed by fecal diversion alone.
dc.language.iso eng
dc.source World journal of surgery
dc.source.uri https://link.springer.com/journal/268
dc.title Civilian extraperitoneal rectal gunshot injuries: Surgical management made simpler
dc.type Journal Article
dc.date.updated 2016-01-08T08:50:58Z
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Medicine en_ZA
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Navsaria, P. H., Edu, S., & Nicol, A. J. (2007). Civilian extraperitoneal rectal gunshot injuries: Surgical management made simpler. <i>World journal of surgery</i>, http://hdl.handle.net/11427/24339 en_ZA
dc.identifier.chicagocitation Navsaria, Pradeep H, Sorin Edu, and Andrew J Nicol "Civilian extraperitoneal rectal gunshot injuries: Surgical management made simpler." <i>World journal of surgery</i> (2007) http://hdl.handle.net/11427/24339 en_ZA
dc.identifier.vancouvercitation Navsaria PH, Edu S, Nicol AJ. Civilian extraperitoneal rectal gunshot injuries: Surgical management made simpler. World journal of surgery. 2007; http://hdl.handle.net/11427/24339. en_ZA
dc.identifier.ris TY - AU - Navsaria, Pradeep H AU - Edu, Sorin AU - Nicol, Andrew J AB - Background: Rectal injuries are associated with significant morbidity and mortality. Controversy persists regarding routine presacral drainage, distal rectal washout (DRW), and primary repair of extraperitoneal rectal injuries. This retrospective review was performed to determine the outcome of rectal injuries in an urban trauma center with a high incidence of penetrating trauma where a non-aggressive surgical approach to these injuries is practiced. Methods: The records of all patients with a full-thickness penetrating rectal injury admitted to the Trauma Center at Groote Schuur Hospital over a 4-year period were reviewed. These were reviewed for demographics, injury mechanism and perioperative management, anatomical site of the rectal injury, associated intra-abdominal injuries and their management. Infectious complications and mortality were noted. Intraperitoneal rectal injuries were primarily repaired, with or without fecal diversion. Extraperitoneal rectal injuries were generally left untouched and a diverting colostomy was done. Presacral drainage and DRW were not routinely performed. Results: Ninety-two patients with 118 rectal injuries [intraperitoneal (7), extraperitoneal (59), combined (26)] were identified. Only two extraperitoneal rectal injuries were repaired. None had presacral drainage. Eighty-six sigmoid loop colostomies were done. Two (2.2%) fistula, one rectocutaneous, and one rectovesical, were recorded. There were nine (9.9%) infectious complications: surgical site infection (4), buttock abscess (1), buttock necrosis (1), pubic ramus osteitis (1), septic arthritis (2). No perirectal sepsis occurred. Conclusions Extraperitoneal rectal injuries due to low-velocity trauma can be safely managed by fecal diversion alone. DA - 2007 DB - OpenUCT DP - University of Cape Town J1 - World journal of surgery LK - https://open.uct.ac.za PB - University of Cape Town PY - 2007 T1 - Civilian extraperitoneal rectal gunshot injuries: Surgical management made simpler TI - Civilian extraperitoneal rectal gunshot injuries: Surgical management made simpler UR - http://hdl.handle.net/11427/24339 ER - en_ZA


Files in this item

This item appears in the following Collection(s)

Show simple item record