title: Simplified management of low-energy projectile extraperitoneal rectal injuries.
abstract: BACKGROUND
  Since minimally invasive approach for fecal diversion in low-velocity extraperitoneal rectal injuries (EPRI) has a lower morbidity than open, and since computed tomography (CT) scan is helpful in ruling out concomitant intraperitoneal injuries (IPI), we utilized both modalities to simplify management of such injuries.
  
  
  METHODS
  Retrospective review of stable patients with EPRI, treated with laparoscopic assisted diversion, after a CT scan, compared with patients with similar injuries that had a negative laparotomy and a colostomy.
  
  
  RESULTS
  The laparoscopy group had a shorter length of stay (3 +/- 2 days versus 7 +/- 2 days), earlier return of bowel function (3 +/- 2 days versus 5 +/- 2 days) and fewer infectious complications. If the CT scan was negative for IPI, none were found on open exploration or laparoscopy.
  
  
  CONCLUSIONS
  If IPI are ruled out with a preoperative CT scan, laparoscopy-assisted colostomy is safe and less morbid.
authors.affiliation: Department of Surgery, Huron Hospital, East Cleveland, Ohio, USA. nahmed@cchseast.org
authors.forename: Naveed
authors.initials: N
authors.lastname: Ahmed
authors.forename: Sanjay
authors.initials: S
authors.lastname: Thekkeurumbil
authors.forename: Viney
authors.initials: V
authors.lastname: Mathavan
authors.forename: Mark
authors.initials: M
authors.lastname: Janzen
authors.forename: James
authors.initials: J
authors.lastname: Tasse
authors.forename: Raphael
authors.initials: R
authors.lastname: Chung
mesh_terms: D003125:Colostomy; D003287:Contrast Media / Q000008:administration & dosage; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D011183:Postoperative Complications; D012007:Rectum / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000601:surgery*
chemical_list: D003287:Contrast Media