Contemporary management of rectal injuries at Level I trauma centers: The results of an American Association for the Surgery of Trauma multi-institutional study

Brown, Carlos V R; Teixeira, Pedro G.; Furay, Elisa; Sharpe, John P.; Musonza, Tashinga; Holcomb, John B.; Bui, Eric; Bruns, Brandon R.; Hopper, H. Andrew; Truitt, Michael S.; Burlew, Clay Cothren; Schellenberg, Morgan; Sava, Jack; Vanhorn, John; Eastridge, P. C.Brian; Cross, Alicia M.; Vasak, Richard; Vercruysse, Gary; Curtis, Eleanor; Haan, James M.; Coimbra, Raúl; Bohan, Phillip Kemp; Gale, Stephen C.; Bendix, Peter

doi:10.1097/ta.0000000000001739

Cited by 46 publications

(32 citation statements)

References 23 publications

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“…Unfortunately, it is not known why grade I injuries were diverted. Nevertheless, the apparent successful conservative management of 26 grade II injuries is intriguing [9].…”

Section: Discussionmentioning

confidence: 99%

Conservative management of a traumatic non-destructive grade II extraperitoneal rectal injury following motor vehicle collision

Karadimos

Aldridge

Menon

2019

Trauma Case Reports

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“…Unfortunately, it is not known why grade I injuries were diverted. Nevertheless, the apparent successful conservative management of 26 grade II injuries is intriguing [9].…”

Section: Discussionmentioning

confidence: 99%

Conservative management of a traumatic non-destructive grade II extraperitoneal rectal injury following motor vehicle collision

Karadimos

Aldridge

Menon

2019

Trauma Case Reports

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“…Adjunctive measures, such as rectal washout and pre-sacral drain placement, gained popularity in this era but remained controversial. A recent multi-center retrospective review including 785 patients with rectal injuries provides additional data regarding the management of these injuries [12]. In this series, extraperitoneal injuries were successfully managed with either direct repair, observation, or proximal diversion.…”

Section: Discussionmentioning

confidence: 99%

Femoral Head Dislocation into the Rectum Following Blunt Trauma

Ebeling

Clark

Erwin

et al. 2019

Cureus

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Traumatic hip dislocations require prompt diagnosis and treatment to prevent avascular necrosis of the femoral head. This injury is further complicated when there is an ipsilateral femur fracture. Here, we present what is likely the first reported case of a patient with traumatic hip dislocation and ipsilateral femur fracture with transrectal displacement of the femoral head. The patient presented to a level one trauma center in 2006 as a transfer from another facility after being thrown from a pickup truck. Upon initial evaluation, a foreign body was palpated in the rectum. Computed tomography (CT) imaging showed that the right femoral head was lodged within the pelvis. In the operating room, an exploratory laparotomy was performed, and anoscopy confirmed the placement of the femoral head within the rectal lumen. The femoral head was extracted from the rectum transanally. The operation was abbreviated, as the patient became hemodynamically unstable, and he was taken to the intensive care unit. He returned to the operating room the following day for a repeat washout and proximal diversion. Despite numerous orthopedic procedures and operative washouts, he ultimately underwent a right hip disarticulation. Physicians should be aware that intracorporeal femoral head displacement is possible in select patients who have experienced a high-energy trauma mechanism. This is a complicated, highly morbid injury that poses various management challenges to orthopedic and acute care surgeons.

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“…Rectal injuries are uncommon and usually associated with military trauma. In combat, such injuries are associated with high‐energy blunt trauma, whereas in the civilian setting, they are typically low‐energy penetrating trauma 1–3 . Mortality associated is about 3%, but morbidity remains high (25%) due to the development of intra‐abdominal sepsis 1 .…”

Section: Figurementioning

confidence: 99%

“…In combat, such injuries are associated with high-energy blunt trauma, whereas in the civilian setting, they are typically lowenergy penetrating trauma. [1][2][3] Mortality associated is about 3%, but morbidity remains high (25%) due to the development of intraabdominal sepsis. 1 Historically, management of such injuries includes a combination of repair, resection, proximal diversion, distal rectal washout or presacral drainage.…”

mentioning

confidence: 99%