Trans-anal rectal injuries.
Singapore Med J
; 49(1): 54-6, 2008 Jan.
Article
en En
| MEDLINE
| ID: mdl-18204770
INTRODUCTION: The diagnosis of trans-anal rectal injuries is usually delayed because of the patient's denial. Some of these injuries are self-inflicted or caused by criminal assault, leading to delayed presentation. We aimed to study the causes, clinical presentation, management and clinical outcome of transanal rectal injuries. METHODS: The records of 12 patients (nine males) with a median age of 36.5 (range 20-64) years, had trans-anal rectal injury and were treated between 1993 and 2006 at Al-Ain Hospital, were reviewed. RESULTS: Injury was caused by a fall on a sharp object in five patients, by a rectal foreign body in two patients, by a compressed air hose in two patients, by sexual assault in two patients, and by rectal cleansing enema in one patient. Seven patients presented two hours after the injury, four patients within 8-24 hours, and one sexually-assaulted patient presented after seven days. Injuries were in the anterior rectal wall in seven, in the rectosigmoid junction in three, and in the anorectal region in two patients. Ten patients presented with peritonitis, four were in shock, seven had bleeding per rectum, and two had a weak sphincter. The complication rate was significantly higher in the colostomy patients compared with primary repair (5/6 compared with 0/6, p-value is less than 0.02, Fisher's exact test). All patients survived. The median (range) hospital stay was ten (9-72) days. CONCLUSION: Diagnosis of trans-anal rectal injuries is usually delayed because of late presentation. Sexual assault should be suspected following rectal injuries. Colostomy is not always mandatory.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Canal Anal
/
Recto
/
Heridas no Penetrantes
/
Heridas Penetrantes
Límite:
Adult
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Singapore Med J
Año:
2008
Tipo del documento:
Article
País de afiliación:
Emiratos Árabes Unidos
Pais de publicación:
India