Civilian extraperitoneal rectal gunshot injuries: Surgical management made simpler
| 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.date.updated | 2016-01-08T08:50:58Z | |
| 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.identifier | http://dx.doi.org/10.1007/s00268-007-9045-z | |
| 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.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.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 |
| dc.identifier.uri | http://hdl.handle.net/11427/24339 | |
| 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.language.iso | eng | |
| dc.publisher.department | Department of Medicine | en_ZA |
| dc.publisher.faculty | Faculty of Health Sciences | en_ZA |
| dc.publisher.institution | University of Cape Town | |
| 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 | |
| uct.type.filetype | Text | |
| uct.type.filetype | Image |