title: Civilian rectal trauma: a changing perspective.
abstract: BACKGROUND
  Recently the Organ Injury Scaling Committee of the American Association for the Surgery of Trauma developed a Rectal Injury Scaling System (RISS). Little data exist regarding its clinical utility.
  
  
  METHODS
  We retrospectively reviewed 45 patients with rectal injuries to assess the impact of the RISS on patient management and outcome. We compared RISS grade I patients (group I, partial-thickness injury) with patients with grades 2, 3, and 4 injuries (group II, full-thickness injury).
  
  
  RESULTS
  Group II underwent distal rectal washout and repair of the injury twice as often and had a significantly higher rate of diversion of the fecal stream. This was associated with a 3-fold increase in complications. The only complications in group I were in patients managed with diversion of the fecal stream and distal rectal washout.
  
  
  CONCLUSIONS
  Our data suggest that aggressive surgical management for RISS grade I injury may not be necessary. Implementation of therapy based on the RISS may improve outcomes of civilian rectal trauma.
authors.affiliation: Department of Surgery, Hennepin County Medical Center, Minneapolis, Minn 55415, USA.
authors.forename: J J
authors.initials: JJ
authors.lastname: Morken
authors.forename: J J
authors.initials: JJ
authors.lastname: Kraatz
authors.forename: E G
authors.initials: EG
authors.lastname: Balcos
authors.forename: M J
authors.initials: MJ
authors.lastname: Hill
authors.forename: A L
authors.initials: AL
authors.lastname: Ney
authors.forename: M A
authors.initials: MA
authors.lastname: West
authors.forename: J M
authors.initials: JM
authors.lastname: Van Camp
authors.forename: R T
authors.initials: RT
authors.lastname: Zera
authors.forename: D M
authors.initials: DM
authors.lastname: Jacobs
authors.forename: M D
authors.initials: MD
authors.lastname: Odland
authors.forename: J L
authors.initials: JL
authors.lastname: Rodriguez
mesh_terms: D000293:Adolescent; D000328:Adult; D003125:Colostomy / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D010808:Physical Examination; D011183:Postoperative Complications / Q000401:mortality; D012002:Rectal Diseases / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D012007:Rectum / Q000293:injuries*; D012189:Retrospective Studies; D016896:Treatment Outcome