[Traumatic lesions of the anorectum].
Injuries of the colon and rectum are common surgical problems. Lesions can be classified into four groups according to the site of damage and the presence of sphincter tears: 1. intraperitoneal perforation without sphincter damage 2. intraperitoneal perforation with sphincter damage 3. extraperitoneal perforation without sphincter damage 4. extraperitoneal perforation with sphincter damage From 1990 to 1998, 11 patients, 7 males and 4 females presenting an anal and/or rectal trauma were admitted in Geneva University Hospital. 8 patients were admitted as an emergency, the 3 others had been transferred to correct an incontinent post traumatic pathology. No mortality. A terminal colostomy was performed in all patients with intraperitoneal injury and in 5 patients with combined extraperitoneal and anal sphincter injury. All sphincter lesions were sutured as an emergency (6 cases). In 3 patients we performed an overlapping sphincteroplasty. 2 patients with persisting incontinence were cured by a dynamic stimulated graciloplasty. The choice of treatment of anorectal trauma includes broad spectrum antibiotherapy, cleaning of the rectum, sphincter repair. A terminal diverting colostomy and laparotomy must be achieved in case of intraperitoneal injury, large extraperitoneal lesion, severe perineal laceration with or without pelvic fracture.
Roche
B
B
Policlinique de Chirurgie, Hôpitaux Universitaire de Genève.
Michel
J M
JM
Deléaval
J
J
Peter
R
R
Marti
M C
MC
D001003:Anal Canal / Q000293:injuries* / Q000601:surgery; D003106:Colon / Q000293:injuries* / Q000601:surgery; D003125:Colostomy; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D012007:Rectum / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome
Lésions traumatiques de l'anorectum.