title: [Perianal and rectal impalement injuries].
abstract: Perianal impalement injuries with or without involvement of the anorectum are rare. Apart from a high variety of injury patterns, there is a multiplicity of diagnostic and therapeutic options. Causes of perianal impalement injury are gunshot, accidents, and medical treatment. The diagnostic work-up includes digital rectal examination followed by rectoscopy and flexible endoscopy under anaesthesia. We propose a new classification for primary extraperitoneal perianal impalement injuries in four stages in which the extension of sphincter and/or rectum injury is of crucial importance. Therapeutic aspects such as wound treatment, enterostomy, drains, and antibiotic treatment are discussed. The proposed classification encompasses recommendations for stage-adapted management and prognosis of these rare injuries.
authors.affiliation: Chirurgische Universitätsklinik Mannheim, Klinikum Mannheim gGmbH, Theodor-Kutzer-Ufer 1-3, 68167 Mannheim.
authors.forename: A K
authors.initials: AK
authors.lastname: Joos
authors.forename: A
authors.initials: A
authors.lastname: Herold
authors.forename: P
authors.initials: P
authors.lastname: Palma
authors.forename: S
authors.initials: S
authors.lastname: Post
mesh_terms: D001003:Anal Canal / Q000293:injuries* / Q000601:surgery; D019072:Antibiotic Prophylaxis; D003125:Colostomy; D019317:Evidence-Based Medicine; D006801:Humans; D007081:Ileostomy; D010502:Perineum / Q000293:injuries* / Q000601:surgery; D011379:Prognosis; D012007:Rectum / Q000293:injuries* / Q000601:surgery; D012086:Reoperation; D012307:Risk Factors; D013396:Suction; D013536:Suture Techniques; D014945:Wound Healing / Q000502:physiology; D014948:Wounds, Gunshot / Q000175:diagnosis / Q000601:surgery; D014950:Wounds, Penetrating / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*